Faculty Collaboration Database

Moderate, Short-Term, Local Hyperglycemia Attenuates Forearm Endothelium-Dependent Vasodilation After Transient Ischemia-Reperfusion in Human Volunteers. J Cardiothorac Vasc Anesth 2017 Oct;31(5):1649-1655

Date

03/13/2017

Pubmed ID

28284926

DOI

10.1053/j.jvca.2016.11.040

Scopus ID

2-s2.0-85015618612 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

OBJECTIVE: Acute hyperglycemia causes endothelial dysfunction in diabetic patients, abolishes ischemic pre- and postconditioning, and is an independent predictor of adverse outcome after myocardial infarction in nondiabetic patients. Its effects on endothelial-dependent vasodilation are controversial in healthy subjects. The authors studied the effect of moderate short-term local hyperglycemia on forearm endothelium-dependent vasodilation in healthy volunteers.

DESIGN: Randomized, crossover, blinded, 2-visit, pilot design.

SETTING: Veterans Affairs Medical Center.

PARTICIPANTS: Five male and 3 female healthy adult volunteers (23±4 years; height 171±13 cm; weight 66±9 kg; [mean±standard error of the mean]).

INTERVENTIONS: At each visit, volunteers received an infusion through a brachial artery catheter of either 0.9% saline or dextrose in the experimental, non-dominant arm, to establish mild forearm hyperglycemia. Hemodynamics and forearm blood flow (FBF; plethysmography) were measured at baseline, during brachial artery infusions of acetylcholine in consecutive increments (5, 10, and 15 μg/min), before ischemia (20 min, blood pressure cuff at 200 mmHg), and after 15 minutes of reperfusion. Blood glucose and insulin concentrations were determined from venous samples. The effect of duration of intra-arterial dextrose on FBF was examined.

MEASUREMENTS AND MAIN RESULTS: Dextrose increased steady-state blood glucose concentration in the experimental but not the control arm (dominant arm). Dextrose increased FBF compared with saline (4.5±0.5 v 2.6±0.4 mL/min/100 g of tissue, respectively). Acetylcholine caused similar increases in FBF in the absence and presence of dextrose (+239±90% v+203±75%, respectively, during 15 μg/min). The duration of dextrose did not affect this acetylcholine-induced vasodilation. Acetylcholine-stimulated increases in FBF were attenuated in dextrose-treated versus saline after reperfusion (+180±18% v+257±53%, respectively, during 10 μg/min). Interventions in the experimental arm did not affect FBF in the control arm.

CONCLUSION: These results indicated that moderate, short-term, local hyperglycemia induced by intra-arterial administration of dextrose attenuated forearm endothelial-dependent vasodilation after ischemia-reperfusion injury in healthy volunteers.

Author List

Ebert TJ, Novalija J, Barney JA, Uhrich TD, Arain SR, Freed JK, Pagel PS

Authors

Thomas J. Ebert MD, PhD Vice Chair, Professor in the Anesthesiology department at Medical College of Wisconsin
Julie K. Freed MD, PhD Associate Professor in the Anesthesiology department at Medical College of Wisconsin
Jutta Novalija MD, PhD Professor in the Anesthesiology department at Medical College of Wisconsin
Paul S. Pagel MD, PhD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adult
Cross-Over Studies
Double-Blind Method
Endothelium, Vascular
Female
Forearm
Glucose
Healthy Volunteers
Humans
Hyperglycemia
Infusions, Intra-Arterial
Male
Pilot Projects
Regional Blood Flow
Reperfusion Injury
Single-Blind Method
Vasodilation
Young Adult