Ischemic heart failure mortality is not predicted by cardiac insulin resistance but by diabetes per se and coronary flow reserve: A retrospective dynamic cardiac 18 F-FDG PET study

The connection between peripheral insulin resistance (IR) and coronary artery disease is well-established. Both are major risk factors for the development of ischemic cardiomyopathy potentially leading to heart failure (HF). Whether cardiac IR also impacts overall survival and morbidity is still deb...

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Published in:Metabolism, clinical and experimental clinical and experimental, 2021-10, Vol.123, p.154862
Main Authors: Luong, Thien Vinh, Pedersen, Mette Glavind Bülow, Kjærulff, Mette Louise Blouner Gram, Madsen, Simon, Lauritsen, Katrine Meyer, Tolbod, Lars Poulsen, Søndergaard, Esben, Gormsen, Lars Christian
Format: Article
Language:English
Subjects:
Coronary Circulation
Diabetes Mellitus, Type 2 - physiopathology
Female
Fluorodeoxyglucose F18 - administration & dosage
Humans
Insulin Resistance
Male
Myocardial Ischemia - diagnostic imaging
Myocardial Ischemia - mortality
Positron-Emission Tomography - methods
Retrospective Studies
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Summary:The connection between peripheral insulin resistance (IR) and coronary artery disease is well-established. Both are major risk factors for the development of ischemic cardiomyopathy potentially leading to heart failure (HF). Whether cardiac IR also impacts overall survival and morbidity is still debated. We therefore aimed to test if cardiac IR predicts mortality and major cardiovascular events (MACE) in patients with HF scheduled for cardiac viability testing before revascularization. This retrospective study included 131 patients with a clinical diagnosis of ischemic HF (114 (87%) male, 33 (25%) with diabetes) referred to a viability Rubidium-82 (perfusion) and dynamic F-Fluorodeoxyglucose (metabolism) positron emission tomography combined with computed tomography prior to a potential revascularization procedure. Cardiac IR was assessed by myocardial glucose uptake (MGU) in a remote (non-scarred) area of the left ventricle during a hyperinsulinemic-euglycemic clamp (1mIE/kg/min). MGU correlated with skeletal muscle glucose uptake (p 
ISSN:1532-8600