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European Heart Journal 1985 6(5):458-464;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Metabolic effects of high doses of insulin during acute left ventricular failure in dogs

O. REIKERÅS*,, P. GUNNES{dagger}, D. SøRLIE*, R. EKROTH{ddagger} and O.D. MjØS§

*Cardiovascular Section, Surgical Department, University of Tromsø Norway
{dagger}Section of Cardiology, Medical Department, Institute of Clinical Medicine, University of Tromsø Norway
§Department of Physiology, Institute of Medical Biology, University of Tromsø Norway
{ddagger}Department of Cardiothoracic Surgery, Sahlgrenska Hospital, University of Gothenburg Sweden

Received 5 November 1984; revised 28 January 1985; .

Olav Reikeràs, Department of Surgery, Tromsø University Hospital. N-9012 Tromsø. Norway.

Abstract

Metabolic effects of pharmacological doses of insulin were studied during acute ischaemic heart failure in 7 dogs. Severe depression of left ventricular performance was induced by embolization of the left main coronary artery with 50 µm plastic microspheres. This was followed by a significant reduction in myocardial blood flow and oxygen consumption. After a period of stabilization of the haemodynamic and metabolic variables, 300 IU of insulin free of glucagon and calcium was injected as a bolus dose. Glucose and potassium were given to maintain their plasma concentrations. Insulin significantly improved performance of the failing left ventricle. Myocardial blood flow was significantly increased, whereas myocardial oxygen consumption was unchanged. Insulin significantly reduced arterial concentrations and myocardial uptake of free fatty acids, while myocardial uptake of glucose and lactate showed a non-significant increase. In conclusion, pharmacological doses of insulin significantly improve cardiac pump function without increasing myocardial oxygen consumption during acute ischaemic left ventricular failure in dogs. This may be partly related to reduced myocardial uptake of free fatty acids relative to that of glucose.

Key Words: Free fatty acids • glucose • heart failure • inotropy • lactate • myocardial ischaemia


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