Hyperglycemia reduces coronary collateral blood flow through a nitric oxide-mediated mechanism.
We tested the hypothesis that hyperglycemia alters retrograde coronary collateral blood flow by a nitric oxide-mediated mechanism in a canine Ameriod constrictor model of enhanced collateral development. Administration of 15% dextrose to increase blood glucose concentration to 400 or 600 mg/dl decreased retrograde blood flow through the left anterior descending coronary artery to 78 +/- 9 and 82 +/- 8% of baseline values, respectively. In contrast, saline or L-arginine (400 mg x kg(-1) x h(-1)) had no effect on retrograde flow. Coronary hypoperfusion and 1 h of reperfusion decreased retrograde blood flow similarly in saline- or L-arginine-treated dogs (76 +/- 11 and 89 +/- 4% of baseline, respectively), but these decreases were more pronounced in hyperglycemic dogs (47 +/- 10%). L-arginine prevented decreases in retrograde coronary collateral blood flow during hyperglycemia (100 +/- 5 and 95 +/- 6% of baseline at blood glucose concentrations of 400 and 600 mg/dl, respectively) and after coronary hypoperfusion and reperfusion (84 +/- 14%). The results suggest that hyperglycemia decreases retrograde coronary collateral blood flow by adversely affecting nitric oxide availability.
Kersten
J R
JR
Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA. jkersten@mcw.edu
Toller
W G
WG
Tessmer
J P
JP
Pagel
P S
PS
Warltier
D C
DC
D000818:Animals; D001120:Arginine / Q000494:pharmacology; D003097:Collateral Circulation / Q000187:drug effects / Q000502:physiology*; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology*; D004195:Disease Models, Animal; D004285:Dogs; D006943:Hyperglycemia / Q000378:metabolism / Q000503:physiopathology*; D008833:Microcirculation / Q000187:drug effects / Q000502:physiology; D017202:Myocardial Ischemia / Q000378:metabolism / Q000503:physiopathology; D015428:Myocardial Reperfusion Injury / Q000378:metabolism / Q000503:physiopathology; D009569:Nitric Oxide / Q000378:metabolism*
D009569:Nitric Oxide; D001120:Arginine