Korean Circ J.  2008 Apr;38(4):220-226. 10.4070/kcj.2008.38.4.220.

The Effect of Hyperglycemia Induced by Oral Glucose Loading on Coronary Flow Reserve

• Song MJ
• Kim NH
• Lee AS
• Choi JH
• Kim YC
• Kim SH
• Park EM
• Rhee SJ
• Yun KH
• Lee EM
• Yoo NJ
• Oh SK
• Jeong JW

• KMID: 2225824
• DOI: http://doi.org/10.4070/kcj.2008.38.4.220

Abstract

BACKGROUND AND OBJECTIVES: Patients with chronic diabetes mellitus (DM) have an increased risk of cardiac dysfunction and mortality. There is some evidence that suggests acute hyperglycemia may cause vascular dysfunction. However, it is unknown whether acute, short-term hyperglycemia affects coronary microcirculation function in healthy subjects. The present study was undertaken to explore this issue.
SUBJECTS AND METHODS
We evaluated 20 healthy males who had no history of DM or impaired glucose tolerance, ranging in age from 23 to 36 years (25.9+/-3.3 years). We checked blood sugar, 12-lead electrocardiography, pulse wave velocity, and coronary flow reserve using echocardiography during fasting, and 30, 60, 90, and 120 minutes after ingestion of 75 g of glucose orally.
RESULTS
Non-significant prolongation of the QTc dispersion was observed after the 75 g glucose loading. No significant difference in the pulse wave velocity of the carotid-to-femoral artery, carotid-to-radial artery, or femoral-to-dorsalis pedis artery was observed after the 75 g glucose loading. There was a significant reduction in the coronary flow reserve at 60 (4.06+/-0.75 vs. 3.54+/-0.82, p=0.021) and 90 minutes (4.06+/-0.75 vs. 3.59+/-0.63, p=0.021) after the 75 g glucose loading compared to that on fasting.
CONCLUSION
The results of this study suggest that acute exposure to high circulating glucose levels does not affect heterogeneity of the ventricular repolarization or arterial stiffness, but it does reduce the coronary flow reserve in healthy young men.

Keyword

Glucose; Coronary vessels; Blood flow velocity

MeSH Terms

Arteries
Blood Flow Velocity
Blood Glucose
Coronary Vessels
Diabetes Mellitus
Eating
Echocardiography
Electrocardiography
Fasting
Glucose
Humans
Hyperglycemia
Male
Microcirculation
Population Characteristics
Pulse Wave Analysis
Vascular Stiffness
Blood Glucose
Glucose

Figure

• 

  Fig. 1 Coronary flow reserve in a subject with 24 years old. At baseline (A), resting peak diastolic velocity was 16 cm/sec (top) and hyperemic peak diastolic velocity was 86 cm/sec. Calculated coronary flow reserve at baseline was 86/16=5.38; At 60 min after ingestion of 75 g glucose (B), resting peak diastolic velocity was 20 cm/sec (top) and hyperemic peak diastolic velocity was 92 cm/sec. Calculated coronary flow reserve at baseline was 103/22=4.60.

• 

  Fig. 2 Changes of coronary flow reserve after ingestion of 75 g glucose. *p<0.05 compare to baseline.

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