title: A pilot study to assess whether glucagon-like peptide-1 protects the heart from ischemic dysfunction and attenuates stunning after coronary balloon occlusion in humans.
abstract: BACKGROUND
  The incretin hormone glucagon-like peptide-1 (GLP-1) has been shown to have cardioprotective properties in animal models of ischemia and infarction due to promotion of myocardial glucose uptake and suppression of apoptosis. We investigated whether GLP-1 protected the heart from dysfunction caused by supply ischemia during percutaneous coronary intervention (PCI).
  
  
  RESULTS
  Twenty patients with normal left ventricular (LV) function and single-vessel coronary disease within the left anterior descending artery undergoing elective PCI were studied. A conductance catheter was placed into the LV through the femoral artery, and pressure-volume loops were recorded at baseline and during a 1-minute low-pressure balloon occlusion at the site of the stenosis. The patients were randomized to receive an infusion of either GLP-1(7-36) amide at 1.2 pmol/kg per minute or saline immediately after the first balloon occlusion. Coronary balloon occlusion caused LV stunning in the control group with cumulative LV dysfunction on subsequent occlusion that was not seen in the GLP-1 group. GLP-1 improved recovery of LV systolic and diastolic function at 30 minutes after balloon occlusion compared with control (delta dP/dt(max) from baseline, -1.6% versus -12.2%; P=0.02) and reduced the LV dysfunction after the second balloon occlusion (delta dP/dt(max), -13.1% versus -25.3%; P=0.01).
  
  
  CONCLUSIONS
  In this pilot study, infusion of GLP-1 has been demonstrated to reduce ischemic LV dysfunction after supply ischemia during coronary balloon occlusion in humans and mitigates stunning. The findings require confirmation in a larger scale clinical trial.
  
  
  BACKGROUND
  URL: http://www.isrctn.org. Unique identifier: ISRCTN 77442023.
authors.affiliation: Department of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Read
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Hoole
authors.forename: Paul A
authors.initials: PA
authors.lastname: White
authors.forename: Fakhar Z
authors.initials: FZ
authors.lastname: Khan
authors.forename: Michael
authors.initials: M
authors.lastname: O'Sullivan
authors.forename: Nick E J
authors.initials: NE
authors.lastname: West
authors.forename: David P
authors.initials: DP
authors.lastname: Dutka
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D021721:Balloon Occlusion / Q000009:adverse effects; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000097:blood / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000503:physiopathology*; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D017682:Myocardial Stunning / Q000517:prevention & control*; D010865:Pilot Projects; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D005230:Fatty Acids, Nonesterified; D052216:Glucagon-Like Peptide 1