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Heart. 2012 Mar;98(5):408-13. doi: 10.1136/hrt.2010.219345. Epub 2011 May 10.

Cardioprotection against ischaemia induced by dobutamine stress using glucagon-like peptide-1 in patients with coronary artery disease.

Author information

1
Department of Cardiovascular Medicine, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.

Abstract

BACKGROUND:

Glucagon-like peptide-1 (GLP-1) is an incretin hormone which has been shown to promote myocardial glucose uptake. Its pharmacological properties as a cardioprotective agent are attractive because it has a short half-life and there is minimal risk of hypoglycaemia.

OBJECTIVE:

To assess the hypothesis that intravenous infusion of GLP-1 would protect the heart from ischaemic left ventricular (LV) dysfunction during dobutamine stress echocardiography (DSE) in patients with coronary artery disease (CAD).

DESIGN:

Randomised crossover study.

PATIENTS AND INTERVENTIONS:

14 patients with CAD and good LV function awaiting revascularisation underwent two DSE scans in a randomised order. GLP-1 was infused intravenously at 1.2 pmol/kg/min starting 30 min before the DSE for one of the scans and the other scan acted as a control.

MAIN OUTCOME MEASUREMENTS:

Global and regional wall LV function assessed using tissue Doppler imaging at rest, peak stress and 30 min into recovery.

RESULTS:

Global LV function was greater at peak stress during GLP-1 infusion compared with control (ejection fraction 77.0±4.4 vs 70.8±5.0%, p<0.0001; mitral annular systolic velocity 12.18±3.10 vs 11.31±3.11 cm/s, p=0.0004). GLP-1 infusion improved regional wall LV function in 12 non-apical segments assessed by velocity, strain and strain rate. This beneficial effect was predominantly seen in ischaemic segments. In recovery, infusion of GLP-1 mitigated the post-ischaemic stunning seen in the control scan.

CONCLUSION:

Intravenous infusion of GLP-1 protects the heart from ischaemic LV dysfunction induced by dobutamine stress in patients with CAD.

CLINICAL TRIAL REGISTRATION:

URL: http://isrctn.org.

REGISTRATION NUMBER:

ISRCTN 69686930.

PMID:
21561896
DOI:
10.1136/hrt.2010.219345
[Indexed for MEDLINE]

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