Tight Glycemic Control Reduces Heart Inflammation and Remodeling During Acute Myocardial Infarction in Hyperglycemic Patients
| Autor: | Emilio Musacchio, Michele Portoghese, Mario Siniscalchi, Giuseppe Paolisso, Raffaele Marfella, Clara Di Filippo, Francesco Rossi, Franca Ferraraccio, Maria Rosaria Rizzo, Michele D'Amico |
|---|---|
| Přispěvatelé: | Marfella, Raffaele, DI FILIPPO, Clara, Portoghese, M, Ferraraccio, Franca, Rizzo, Maria Rosaria, Siniscalchi, M, Musacchio, E, D'Amico, Michele, Rossi, Francesco, Paolisso, Giuseppe |
| Rok vydání: | 2009 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Inflammation medicine.disease_cause chemistry.chemical_compound Internal medicine medicine Humans Myocardial infarction Coronary Artery Bypass Ventricular remodeling Glycemic post-infarction remodeling Ventricular Remodeling biology business.industry Nitrotyrosine heart inflammation Middle Aged medicine.disease Nitric oxide synthase Oxidative Stress myocardial infarction Endocrinology chemistry Hyperglycemia Circulatory system Cardiology biology.protein Female medicine.symptom business Cardiology and Cardiovascular Medicine Oxidative stress |
| Zdroj: | Journal of the American College of Cardiology. 53(16):1425-1436 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2009.01.041 |
| Popis: | Objectives. We analyzed the molecular mechanisms evoked by tight glycemic control during post-infarction remodeling in human hearts. Background. The molecular mechanisms by which tight glycemic control improves heart remodeling during acute myocardial infarction (AMI) are still largely unknown. Methods. Eighty-eight patients with first AMI undergoing coronary bypass surgery were studied: 38 normoglycemic patients served as the control group; hyperglycemic patients (glucose =140 mg/dl) were randomized to intensive glycemic control (IGC) (n = 25; glucose 80 to 140 mg/dl) or conventional glycemic control (CGC) (n = 25; glucose 180 to 200 mg/dl) for almost 3 days before surgery, with insulin infusion followed by subcutaneous insulin treatment. Echocardiographic parameters were investigated at admission and after treatment period. During surgery, oxidative stress (nitrotyrosine, superoxide anion [O2 –] production, inducible nitric oxide synthase [iNOS]),inflammation (nuclear factor kappa B [NF_B], tumor necrosis factor [TNF]-a, and apoptosis (caspase-3) were analyzed in biopsy specimens taken from the peri-infarcted area. Results. Compared with normoglycemic patients, hyperglycemic patients had higher myocardial performance index (MPI) (p < 0.05), reduced ejection fraction (p 0.05), more nitrotyrosine, iNOS, and O2 _ production, more macrophages, T-lymphocytes, and HLA-DR (Dako, Milan, Italy) cells, and more NF_B-activity, TNF-a, and caspase-3 levels (p < 0.01) in peri-infarcted specimens. After the treatment period, plasma glucose reduction was greater in the IGC than in the CGC group (p < 0.001). Compared with IGC patients, CGC patients had higher MPI (p _0.02), had lower ejection fraction (p < 0.05), and had more markers of oxidative stress, more inflammation and apoptosis (p < 0.01) in peri-infarcted specimens. Conclusions. Tight glycemic control, by reducing oxidative stress and inflammation, might reduce apoptosis in peri-infarcted areas and remodeling in AMI patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|