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. 2022 Dec 13;9(12):456.
doi: 10.3390/jcdd9120456.

Glucose-Induced Hemodynamic and Metabolic Response of Skeletal Muscle in Heart Failure Patients with Reduced vs. Preserved Ejection Fraction-A Pilot Study

Michael Boschmann  1 , Lars Klug  1 , Frank Edelmann  2   3 , Anja Sandek  4   5 , Stephan von Haehling  4   5 , Hans-Dirk Düngen  2 , Jochen Springer  6 , Stefan D Anker  2   3   6 , Wolfram Doehner  2   3   6 , Nadja Jauert  2   3   6   7
Affiliations

Glucose-Induced Hemodynamic and Metabolic Response of Skeletal Muscle in Heart Failure Patients with Reduced vs. Preserved Ejection Fraction-A Pilot Study

Michael Boschmann et al. J Cardiovasc Dev Dis. .

Abstract

(1) Background: Insulin resistance (IR) is a characteristic pathophysiologic feature in heart failure (HF). We tested the hypothesis that skeletal muscle metabolism is differently impaired in patients with reduced (HFrEF) vs. preserved (HFpEF) ejection fraction. (2) Methods: carbohydrate and lipid metabolism was studied in situ by intramuscular microdialysis in patients with HFrEF (59 ± 14y, NYHA I-III) and HFpEF (65 ± 10y, NYHA I-II) vs. healthy subjects of similar age during the oral glucose load (oGL); (3) Results: There were no difference in fasting serum and interstitial parameters between the groups. Blood and dialysate glucose increased significantly in HFpEF vs. HFrEF and controls upon oGT (both p < 0.0001), while insulin increased significantly in HFrEF vs. HFpEF and controls (p < 0.0005). Muscle tissue perfusion tended to be lower in HFrEF vs. HFpEF and controls after the oGL (p = 0.057). There were no differences in postprandial increases in dialysate lactate and pyruvate. Postprandial dialysate glycerol was higher in HFpEF vs. HFrEF and controls upon oGL (p = 0.0016); (4) Conclusion: A pattern of muscle glucose metabolism is distinctly different in patients with HFrEF vs. HFpEF. While postprandial IR was characterized by impaired tissue perfusion and higher compensatory insulin secretion in HFrEF, reduced muscle glucose uptake and a blunted antilipolytic effect of insulin were found in HFpEF.

Keywords: insulin resistance; metabolism; microdialysis; skeletal muscle.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Plasma glucose and insulin levels in patients with heart failure with reduced ejection fraction (rEF, n = 12 men) or patients with preserved ejection fraction (pEF, n = 6 men) and healthy controls (n = 8 men) at baseline and after an oral glucose load (75 g). Data are given as mean ± SE; HFpEF vs. controls, p < 0.0001; HFrEF vs. controls, p = 0.0005.
Figure 2
Figure 2
Skeletal muscle (Vastus lateralis) ethanol ratio and dialysate concentrations glucose, lactate, pyruvate, and glycerol of patients with heart failure with reduced ejection fraction (rEF, n = 12 men) or patients with preserved ejection fraction (pEF, n = 6 men) and healthy controls (n = 8 men) at baseline and after an oral glucose load (75 g). Data are given as mean ± SE; upper right panel: HFpEF vs. controls, p < 0.0001; lower right panel: HFpEF vs. controls, p = 0.0016.
See this image and copyright information in PMC

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