glycogen and Shock

Glucose-insulin-potassium (GIK) given during myocardial ischemia or anoxemia results in improved myocardial function and augments energy reserves of myocardial glycogen (MG). Because many patients with heart disease also have myocardial hypertrophy, our purpose was to examine whether similar elevations in MG can occur in hypertrophic hearts with GIK administration and to study the effect of hypovolemic shock on those MG levels. Mongrel dogs (n = 5) with myocardial hypertrophy underwent serial myocardial biopsies of the left (LV) and right (RV) ventricles, and blood samples were followed by GIK infusion (14.5 ml/kg/hr) for 2 hr. after which the dogs were subjected to 2 hr of hypovolemic shock (mean arterial pressure = 40 mmHg). It was found that after GIK infusion MG was consistently elevated in both RV (.43 +/- .02 to .60 +/- .04 g%) and LV (.63 +/- .07 to .71 +/- .01 g%) and FFA declined (.20 +/- .05 to .05-.01 mEq/liter). The MG responded to hypovolemia by further significant elevations (RV 1.16 +/- .33; LV .82 +/- .17), as did FFA (.38 +/- .21). These results indicate that hypertrophic hearts can indeed respond to GIK infusion by increasing MG in both the RV and LV, as do normal hearts. These hearts then submitted to hypovolemic shock showed a further elevation of MG. The elevated insulin levels post-GIK resulted in suppression of FFA. Thus GIK administration may have a sparing effect on energy stores of the heart during hypovolemic shock, which could have clinical implications in the treatment of patients with hypertrophic myocardia.

Topics: Animals; Blood Glucose; Cardiomegaly; Dogs; Fatty Acids, Nonesterified; Female; Glucose; Glycogen; Heart Ventricles; Insulin; Male; Potassium; Shock

Dogs in shock due to controlled cardiac tamponade for 4 or 12 h were studied to determine which of the metabolic changes characteristic of early shock persisted if the shock state was prolonged. Moderate hyperglycemia and severe lactacidemia were present in the first few hours but the levels returned to near normal values by the end of 12 h. The entry rate of lactic acid into the circulation as well as the rate of glycogenolysis was high in the first 4 h but decreased thereafter even though skeletal muscle glycogen stores were not exhausted. In early but not in late shock glycogen accumulated in the heart. Glucose entry and exit rates were significantly elevated in early shock only. Increased protein utilization and decreased fatty acid mobilization persisted throughout the experimental period. Both in early and late shock the incorporation of labeled free fatty acid into tissue lipids was decreased in most organs. In the diaphragm free fatty acid incorporation only decreased in late shock. In the heart and lung, incorporation was higher than normal in the early stages but was at control levels after 12 h of shock.

Topics: Ammonia; Animals; Aspartate Aminotransferases; Blood Glucose; Dogs; Fatty Acids, Nonesterified; Female; Glycogen; Lactates; Oxygen Consumption; Shock; Time Factors; Urea

Topics: Animals; Carbon Dioxide; Cardiac Tamponade; Dogs; Female; Glycogen; Muscles; Proteins; Shock; Shock, Hemorrhagic; Urea

The size of the lactate pool in canine shock was measured directly by determining the lactate concentration of various organs. All organs tested, except skeletal muscle, had lactate concentrations similar to those of arterial blood. Skeletal muscles had much higher concentrations of lactate than did arterial blood. When 14C-labeled glucose was infused intravenously, it was concluded from the relative specific activities of glucose and lactate in blood that about one-third of lactic acid originates from blood glucose in shock. Only skeletal muscle had lower lactate specific activity than did blood. This is a possible indication that skeletal muscle is the site of production of lactate. Low glucose specific activity in muscle indicates massive glycogen breakdown, which probably serves as a metabolic precursor of lactate. Lactate production from amino acids produced by proteolysis could also play a role.

Topics: Amino Acids; Anaerobiosis; Animals; Blood Glucose; Cardiac Tamponade; Dogs; Female; Glycogen; Lactates; Muscles; Shock

Topics: Animals; Brain; Brain Edema; Brain Neoplasms; Central Nervous System; Dogs; Glycogen; Guinea Pigs; Haplorhini; Hibernation; Humans; Hypoglycemia; Hypoxia; Ischemia; Mice; Microscopy, Electron; Neuroglia; Neurons; Physical Exertion; Rabbits; Radiation Effects; Rats; Seizures; Shock; Starvation

Topics: Animals; Glycogen; Heart; Hypotension, Orthostatic; Methods; Mitosis; Myocardial Infarction; Myocardium; Necrosis; Rabbits; Regeneration; Shock; Time Factors

Topics: Blood; Blood Glucose; Carbohydrate Metabolism; Central Nervous System; Glycogen; Hypoglycemia; Hypoxia; Lactates; Liver; Muscles; Nervous System; Physiology; Portal Vein; Pyruvates; Research; Shock

Topics: Adenosine Triphosphate; Adrenocorticotropic Hormone; Catecholamines; Glucose-6-Phosphatase; Glycogen; Hematocrit; Humans; Ischemia; Lactates; Metabolism; NAD; NADP; Proteins; Pyruvates; Shock; Uric Acid

Topics: Animals; Brain; Brain Chemistry; Glycogen; Metabolism; Rats; Shock

Topics: Dehydration; Female; Glycogen; Glycogenolysis; Heart; Humans; Hypoxia; Muscle, Skeletal; Muscles; Myocardium; Shock; Uterus

Topics: Animals; Blood Glucose; Extremities; Glycogen; Glycogenolysis; Ischemia; Rats; Shock

Topics: Adenosine Triphosphate; Dehydration; Female; Glycogen; Glycogenolysis; Heart; Humans; Hypoxia; Muscles; Myocardium; Shock; Uterus

Topics: Carbohydrate Metabolism; Glycogen; Glycogenolysis; Muscles; Phosphorylases; Phosphorylation; Shock

Topics: Carbohydrate Metabolism; Glycogen; Glycogenolysis; Muscles; Musculoskeletal Physiological Phenomena; Shock

Topics: Glycogen; Heart; Humans; Myocardium; Shock; Tourniquets

Topics: Glycogen; Muscles; Musculoskeletal Physiological Phenomena; Shock

Topics: Glycogen; Glycogenolysis; Myocardium; Shock

Topics: Carbohydrate Metabolism; Glycogen; Glycogen Phosphorylase, Muscle Form; Phosphorylases; Phosphorylation; Shock

Topics: Adenosine Triphosphate; Glycogen; Muscles; Musculoskeletal Physiological Phenomena; Phosphorylation; Shock

Topics: Animals; Burns; Glycogen; Liver; Rats; Shock

Topics: Glycogen; Glycogenolysis; Liver; Shock; Tourniquets

Topics: Glycogen; Humans; Shock