Recent evidence suggests that
glucagon-like peptide-1 (GLP-1) enhances recovery of left ventricular (LV) function after transient coronary artery occlusion. However, it is uncertain whether
GLP-1 has direct effects on normal or ischemic myocardium and whether the mechanism involves increased myocardial
glucose uptake. LV function and myocardial
glucose uptake and
lactate production were measured under basal conditions and after 30 min of low-flow
ischemia and 30 min of reperfusion in the presence and absence of
GLP-1-(7-36) amide. The response was compared with standard
buffer alone or
buffer containing
insulin (100 microU/ml).
GLP-1 decreased the left ventricular developed pressure (baseline: 100 +/- 2 mm Hg;
GLP-1: 75 +/- 3 mm Hg, p < 0.05) and LV dP/dt (baseline: 4876 +/- 65 mm Hg/s;
GLP-1: 4353 +/- 76 mm Hg/s, p < 0.05) in normal hearts.
GLP-1 increased myocardial
glucose uptake (baseline: 33 +/- 3 micromol/min/g;
GLP-1: 81 +/- 7 micromol/min/g, p < 0.05) by increasing
nitric oxide production and
glucose transporter (GLUT)-1 translocation.
GLP-1 enhanced recovery after 30 min of low-flow
ischemia with significant improvements in LV end-diastolic pressure (control: 13 +/- 4 mm Hg;
GLP-1: 3 +/- 2 mm Hg, p < 0.05) and LV developed pressure (control: 66 +/- 6 mm Hg;
GLP-1: 98 +/- 5 mm Hg, p < 0.05).
GLP-1 increased LV function, myocardial
glucose uptake, and GLUT-1 and GLUT-4 translocation during reperfusion to an extent similar to that with
insulin.
GLP-1 has direct effects on the normal heart, reducing contractility, but increasing myocardial
glucose uptake through a non-Akt-1-dependent mechanism, distinct from the actions of
insulin. However,
GLP-1 increased myocardial
glucose uptake and enhanced recovery of cardiac function after low-flow
ischemia in a fashion similar to that of
insulin.