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Alpha-receptor blockade improves muscle perfusion and glucose uptake in heart failure.
- Source :
-
European journal of heart failure [Eur J Heart Fail] 2010 Oct; Vol. 12 (10), pp. 1061-6. Date of Electronic Publication: 2010 Aug 05. - Publication Year :
- 2010
-
Abstract
- Aims: Alpha-adrenergic receptor-mediated vasoconstriction might underlie the insulin resistance seen in conditions associated with increased sympathetic tone, like chronic heart failure (CHF). Alpha-adrenergic receptor blockade by phentolamine could improve forearm blood flow (FBF) and forearm glucose uptake (FGU) in CHF patients.<br />Methods and Results: In 8 CHF patients and in 12 healthy volunteers, FBF (plethysmography) and FGU were measured in both forearms during a 150 min hyperinsulinaemic euglycaemic clamp procedure. During the final 30 min of the clamp, phentolamine was infused into one arm (experimental arm) at a dose of 5.0 μg; min(-1) dL(-1) of forearm volume. Insulin infusion (t = 0-120 min) increased FGU in the two groups, without affecting FBF. In the CHF group, α-adrenergic receptor blockade by phentolamine (t = 120-150 min) further increased FGU in the experimental arm from 3.0 ± 0.7 to 5.0 ± 0.9 μmol min(-1) dL(-1) (P = 0.03). Forearm glucose uptake in the contralateral forearm remained unchanged. In the control group, phentolamine infusion did not increase FGU in the experimental forearm. The increase in blood flow in response to phentolamine was similar in both groups (CHF: 2.1 ± 0.3-7.5 ± 1.7 mL min(-1) dL(-1), P < 0.001; controls 1.5 ± 0.2-5.5 ± 0.8 mL min(-1) dL(-1), P < 0.001 for both, CHF vs. control, P = 0.2). Phentolamine did not affect FBF in the control arm in either group.<br />Conclusion: Alpha-adrenergic receptor blockade improves FGU in CHF patients. As the increase in FBF is similar in controls and CHF patients, this might be explained by an improved glucose-extraction capacity in CHF patients.
- Subjects :
- Adrenergic alpha-Antagonists pharmacology
Analysis of Variance
Blood Glucose drug effects
Blood Glucose genetics
Case-Control Studies
Female
Forearm blood supply
Heart Failure diagnostic imaging
Heart Failure metabolism
Humans
Male
Middle Aged
Muscle, Skeletal drug effects
Muscle, Skeletal metabolism
Phentolamine pharmacology
Plethysmography
Statistics, Nonparametric
Ultrasonography
Young Adult
Adrenergic alpha-Antagonists therapeutic use
Blood Glucose metabolism
Heart
Heart Failure drug therapy
Myocardial Reperfusion
Phentolamine therapeutic use
Vasodilation drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0844
- Volume :
- 12
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- European journal of heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 20693165
- Full Text :
- https://doi.org/10.1093/eurjhf/hfq135