January 1, 1992AJP Heart and Circulatory Physiology
Acute myocardial ischemia causes a transmural gradient in glucose extraction but not glucose uptake
Key result
Acute myocardial ischemia increases subendocardial glucose extraction ~14-fold vs normal perfusion without increasing glucose uptake.
- P<0.01
- n=8
Why the study?
The relationship between myocardial glucose metabolism and blood flow during acute ischemia was not fully understood.
Does acute myocardial ischemia alter glucose extraction and uptake in open-chest swine?
Comparison
60% reduced LAD flow vs normally perfused left circumflex coronary arterial bed
Design
Preclinical experimental study with controlled coronary flow
Follow-up
50 minutes of ischemia
Authors
Discussion
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Implication
Ischemia boosts subendocardial glucose extraction without raising uptake in swine; leaves open whether glycogenolysis drives glycolysis in human acute ischemia.
Structured PICO
Does acute myocardial ischemia alter glucose extraction and uptake in open-chest swine?
P
Population
8 open-chest swine subjected to acute myocardial ischemia for 50 minutes.
I
Intervention
Acute myocardial ischemia induced by reducing left anterior descending coronary arterial (LAD) flow by 60%
C
Comparator
Normally perfused left circumflex coronary arterial bed
O
Outcome
Relationship between myocardial glucose metabolism (glucose extraction, rate of glucose uptake) and blood flowsurrogate
Main Result
Absolute Event Rate: 1.38% vs 0.1%
p-value: p=<0.01
Acute myocardial ischemia stimulates a dramatic increase in glucose extraction that fails to compensate for decreased blood flow, meaning high glycolysis rates are primarily supported by glycogen breakdown rather than increased glucose uptake.
Cite This Study
Stanley et al. (1992) studied Acute myocardial ischemia (n=8). LAD flow reduction (60%) vs. Normally perfused left circumflex flow was evaluated on Subendocardial arterial-venous glucose difference (p=<0.01). Acute myocardial ischemia induced by LAD flow reduction significantly increased subendocardial glucose extraction compared to normal perfusion (1.38 vs 0.10 mumol/ml; P<0.01), but not glucose uptake.