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Articles in PresS, published online ahead of print January 15, 2002
Am J Physiol Endocrinol Metab, 10.1152/ajpendo.00386.2001
Submitted on August 27, 2001
Accepted on January 8, 2002
1 Institute of Clinical Physiology, CNR, Pisa, Italy; Clinical Sciences Centre, Imperial College School of Medicine, London, United Kingdom
2 Clinical Sciences Centre, Imperial College School of Medicine, London, United Kingdom
3 Department of Medicine, University College London, London, United Kingdom
4 Institute of Clinical Physiology, CNR, Pisa, Italy
* To whom correspondence should be addressed. E-mail: paolo.camici{at}csc.mrc.ac.uk.
We investigated the effect of insulin on total and regional myocardial blood flow (MBF) and glucose uptake (MGU) in healthy subjects (50 ± 5 yrs) using positron emission tomography (PET) with oxygen-15 labelled water (H215O) and fluorine-18 labelled fluorodeoxyglucose (18FDG), before and during physiological hyperinsulinaemia (40 mU*min-1*m-2). Twelve male subjects were included in the study. During hyperinsulinaemia, MBF increased from 0.91 ± 0.28 to 1.01 ± 0.31 ml*min-1*g-1 (n = 7 patients, p = 0.05; n = 112 regions, p<0.005). Inter-subject variability ranged from -3.0 % to +41 %. MGU increased from 0.11 ± 0.08 (n = 5) to 0.56 ± 0.08 µmol*min-1*g-1 (p<0.0001) (n = 7). MBF and insulin-mediated MGU were higher in the septum, anterior and lateral wall along short axis regions of the heart. During hyperinsulinaemia, MBF was also higher in the apex and mid-ventricle compared with the base. MBF and MGU were positively correlated before (r = 0.66, p<0.0001) and during hyperinsulinaemia (r = 0.24, p<0.05). These results provide evidence that insulin stimulates myocardial blood flow in normal human hearts, and appears to mainly involve those regions of the heart where insulin mediated MGU is higher. Furthermore, regional distribution of insulin-stimulated MBF and MGU does not appear to be uniform across the left ventricular wall of healthy subjects.
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