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© 2002 by the American Diabetes Association, Inc.
Dose-Dependent Vasodilating Effects of Insulin on Adenosine-Stimulated Myocardial Blood Flow
1 Turku PET Centre, Turku University, Turku, Finland
2 Department of Medicine, Turku University, Turku, Finland
3 Department of Clinical Physiology, Turku University, Turku, Finland
In the peripheral vasculature, insulin induces time- and dose-dependent vasodilation. We have recently demonstrated that insulin potentiates adenosine-stimulated myocardial blood flow. However, it is unknown whether insulin’s effects on the coronary vasculature are dose dependent. In this study, we quantitated myocardial blood flow and adenosine-stimulated coronary flow (140 µg · kg-1 · min-1 for 5 min) in 10 healthy men (age, 32 ± 6 years; BMI, 24.1 ± 1.8 kg/m2) using positron emission tomography and 15O-labeled water. Hyperemic myocardial blood flow was measured in the basal state, during euglycemic physiological hyperinsulinemia (serum insulin 
65 mU/l) and during supraphysiological hyperinsulinemia (serum insulin 460 mU/l). Basal myocardial blood flow was 0.84 ± 0.17 ml · g-1 · min-1. Physiological hyperinsulinemia increased the adenosine-stimulated flow by 20% (from 3.92 ± 1.17 to 4.72 ± 0.96 ml · g- 1 · min-1; P < 0.05). Supraphysiological hyperinsulinemia further enhanced the adenosine-stimulated flow by 19% (to 5.61 ± 1.03 ml · g-1 · min-1; P < 0.05). These effects were not explained by changes in systemic hemodynamics, since coronary resistance decreased during each insulin infusion (P < 0.05). In addition, hyperemic myocardial blood flow responses during insulin stimulation were positively correlated with whole-body glucose uptake. The results demonstrate that insulin is able to enhance hyperemic myocardial blood flow in a dose-dependent manner in healthy subjects. These effects might contribute to the known beneficial dose-dependent effects of insulin on myocardial ischemia.
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