Is hyperglycemia bad for the heart during acute ischemia?

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Presentation transcript:

Is hyperglycemia bad for the heart during acute ischemia? Louis M. Chu, MD, Robert M. Osipov, MD, Michael P. Robich, MD, Jun Feng, MD, PhD, Shizu Oyamada, MD, Cesario Bianchi, MD, PhD, Frank W. Sellke, MD, FAHA, FACS The Journal of Thoracic and Cardiovascular Surgery Volume 140, Issue 6, Pages 1345-1352 (December 2010) DOI: 10.1016/j.jtcvs.2010.05.009 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Size of AAR as a percentage of LV surface area (P = .7, A) and necrotic area as a percentage of AAR (B) in ND and DM animals. Shown are representative slices of ND (C) and DM (D) ventricle, with purple arrows pointing to nonischemic area, red arrows to AAR, and gray arrows to infarct area. Data presented as mean ± SEM comparing ND (n = 8) and DM (n = 8) groups. ∗P < .05. AAR, Area at risk; LV, left ventricular; ND, nondiabetic; DM, diabetic. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1345-1352DOI: (10.1016/j.jtcvs.2010.05.009) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Hemodynamic and functional data. Heart rate (A), developed left ventricular pressure (DLVP, B), mean arterial pressure (MAP, C), left anterior descending (LAD) artery blood flow (D), first derivative of LV pressure over time (+dP/dt, E), and horizontal segmental shortening (SS) axis (F). Pre = baseline, O1 = 30 minutes occlusion, O2 = 60 minutes occlusion, R1 = 30 minutes reperfusion, R2 = 60 minutes reperfusion, R3 = 90 minutes reperfusion, R4 = 120 minutes reperfusion. Data presented as mean ± SEM comparing ND (n = 8) and DM (n = 8) groups. †P < .05. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1345-1352DOI: (10.1016/j.jtcvs.2010.05.009) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Glycogen staining using period acid–Schiff stain in nonischemic DM (A), ischemic DM (B), and ischemic ND (C) myocardium, with black arrows indicating intracellular glycogen. Sections shown are representative of all sections assessed. DM (n = 7) and ND (n = 5) sections were scored in a blinded fashion and glycogen content was compared (D). Data presented as mean ± SEM in arbitrary units. P = .02. DM, Diabetic; ND, nondiabetic. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1345-1352DOI: (10.1016/j.jtcvs.2010.05.009) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Selected cell-survival protein immunblotting results. Ratio of phospho-Akt to total Akt (A), PDK1 (B), HSP27 (C), HSP70 (D), phospho-eNOS (E), phospho-NF-κB (F), phospho-mTOR (G), phospho-p70S6K (H), and phospho-4E-BP1 (I) expression was assessed in the ischemic and nonischemic territories of ND (n = 8) and DM (n = 8) animals. Representative bands are shown, with density expressed as arbitrary units. Data presented as mean ± SEM in arbitrary units (AU). ∗P < .05. PDK1, Pyruvate dehydrogenase kinase 1; HSP, heat shock protein; eNOS, endothelial nitric oxide synthase; mTOR, mammalian target of rapamycin; 4EBP1, 4E-binding protein 1; ND, nondiabetic; DM, diabetic. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1345-1352DOI: (10.1016/j.jtcvs.2010.05.009) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Selected mitogen activated protein kinase immunoblotting results. Ratio of phospho-Erk to total Erk (A), phospho-p90RSK (B), and SAPK/JNK (C) expression was assessed in the ischemic and nonischemic territories of ND (n = 8) and DM (n = 8) animals. Representative bands are shown, with density expressed as arbitrary units. Data presented as mean ± SEM in arbitrary units (AU).∗P < .05. Erk, Extracellularly regulated kinase; SAPK/JNK, stress-activated protein kinase/c-Jun NH2-terminal kinase; ND, nondiabetic; DM, diabetic. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1345-1352DOI: (10.1016/j.jtcvs.2010.05.009) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions