TITLE

The oral glucose tolerance test induces myocardial ischemia in healthy older adults

AUTHOR(S)
Madden, Kenneth M.; Tedder, Gale; Lockhart, Chris
PUB. DATE
June 2007
SOURCE
Clinical & Investigative Medicine;Jun2007, Vol. 30 Issue 3, pE118
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: Postprandial myocardial ischemia has been observed in frail older adults with postprandial hypotension and in patients with severe coronary artery disease, especially after high doses of carbohydrates. The impact of oral glucose on myocardial oxygen supply and demand in healthy older adults without postprandial hypotension or postprandial angina remains unexamined. We hypothesized that oral glucose would result in decreased myocardial oxygen supply relative to demand in a healthy older subject pool free of postprandial hypotension, reversible coronary risk factors and postprandial angina. Methods: 19 older adults (mean age 71.9±1.1 yr) were screened for reversible coronary risk factors. Subjects were given a standardized oral glucose load (75 g) or a sham isovolumetric unsweetened drink during two separate sessions. Indirect measures of oxygen supply (Diastolic Pressure Time Index, DPTI) and demand (Rate Pressure Product, RPP; Systolic Pressure Time Index, SPTI) were obtained from aortic arterial blood pressure waveforms. The Subendocardial Viability Ratio (SEVR, DPTI/SPTI) and DPTI/RPP were also calculated. Results: Oral glucose resulted in decreases in both SEVR (P=0.016) and DPTI/RPP (P=0.028) in the glucose session, indicating a decrease in the relative myocardial oxygen supply to demand. This was due solely to a decrease in myocardial oxygen supply while measures of myocardial oxygen demand did not change significantly. Conclusions: Oral glucose decreases myocardial oxygen supply in older adults free of severe coronary artery disease and without postprandial hypotension. This represents a previously unrecognized complication of oral glucose tolerance tests in healthy older adults.
ACCESSION #
25385130

 

Related Articles

  • Improving postpartum screening rates. Gupta, Yashdeep; Kalra, Sanjay // Archives of Gynecology & Obstetrics;Jun2014, Vol. 289 Issue 6, p1159 

    A letter to the editor is presented in response to the article "Impact of an Intensive Follow-Up Program on the Postpartum Glucose Tolerance Testing Rate" by H. Mendez-Figueroa, J. Daley, P. Breault et al. which appeared in a previous issue of the journal.

  • Exercise Training and Plasma Insulin Responses to an OGTT.  // Journal of Aging & Physical Activity;Jan1995, Vol. 3 Issue 1, p109 

    An abstract of the article "Endurance exercise training improves body composition and plasma insulin responses in 70- to 79-year old men and women," by W.C. Hersey, J.E. Graves, M.L. Pollock, R. Gingerich, R.B. Shireman, G.W. Heath, F. Spireto, S.D. McCole, and J.M. Hagberg, published in the...

  • Brief episode of ischemia activates protective genetic program in rat heart: a gene chip study Simkhovich, Boris Z.; Marjoram, Paul; Poizat, Coralie; Kedes, Larry; Kloner, Robert A. // Cardiovascular Research;Aug2003, Vol. 59 Issue 2, p450 

    Objective: Brief episodes of ischemia of 20 min or less have the potential to protect the heart. Such episodes are associated primarily with reversible ischemic injury yet they induce changes in gene expression. The purpose of the study was to determine whether activation of protective...

  • Comparison of silent and symptomatic ischemia during exercise testing in men. Miranda, Cres P.; Lehmann, Kenneth G.; Lachterman, Bruce; Coodley, Eugene M.; Froelicher, Victor F.; Miranda, C P; Lehmann, K G; Lachterman, B; Coodley, E M; Froelicher, V F // Annals of Internal Medicine;4/15/91, Vol. 114 Issue 8, p649 

    Objective: To compare angina and ST-segment depression during exercise testing, as markers for coronary artery disease.Design: Retrospective analysis of exercise test responses and cardiac catheterization results.Setting: A U.S. Veterans Affairs medical...

  • Chest pain puzzle. Bachman, William R.; Cohen, Mylan C. // Cortlandt Forum;6/25/96, Vol. 9 Issue 6, p170 

    Presents an analysis of a medical case involving the difficulty of treating a 69-year-old woman due to her inability to give an accurate medical history of her cardiac illness and extreme obesity. Limited of her clinical examinations due to her size; Symptoms of ischemic coronary disease;...

  • Cost of Screening for Pre-diabetes Among U.S. Adults. Zhang, Ping; Engelgau, Michael M.; Valdez, Rodolfo; Benjamin, Stephanie M.; Cadwell, Betsy; Narayan, K. M. Venkat // Diabetes Care;Sep2003, Vol. 26 Issue 9, p2536 

    OBJECTIVE — We evaluated various strategies to identify individuals aged 45-74 years with pre-diabetes (either impaired glucose tolerance or impaired fasting glucose). RESEARCH DESIGN AND METHODS — We conducted a cost analysis to evaluate the effectiveness (proportion of cases...

  • Screening for gestational diabetes mellitus. Rey, Evelyne // BMJ: British Medical Journal (International Edition);09/25/99, Vol. 319 Issue 7213, p798 

    Proposes the use of fasting glucose value and glucose tolerance test as a screening tool for gestational diabetes mellitus in Great Britain. Range of values considered normal for fasting glucose and tolerance test; Advantages in the use of fasting glucose value.

  • Ischemic pre-conditioning and per-conditioning of acute coronary syndrome enterovirus infections in elderly patients. Plotkin, Vladimir Y.; Timoshina, Marina A. // Vestnik Sankt-Peterburgskogo Universiteta, Seriia 9: Filologia, ;2013, Issue 3, p19 

    The purpose of the study is to estimate efficiency of the remote ischemic pre-conditioning (RIPC), and per-conditioning (RIPerC) in 73 elderly patients with acute coronary syndrome (ACS; 36 patients with myo-cardial infarction and 37 patients with unstable angina) with and without enterovirus...

  • Ischemic pre-conditioning and per-conditioning of acute coronary syndrome enterovirus infections in elderly patients. Plotkin, Vladimir Y.; Timoshina, Marina A. // Vestnik Sankt-Peterburgskogo Universiteta, Seriia 9: Filologia, ;2013, Issue 3, p266 

    The purpose of the study is to estimate efficiency of the remote ischemic pre-conditioning (RIPC), and per-conditioning (RIPerC) in 73 elderly patients with acute coronary syndrome (ACS; 36 patients with myo-cardial infarction and 37 patients with unstable angina) with and without enterovirus...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics