Acute metabolic responses to myocardial infarction. Changes in glucose utilization and secretion of insulin and growth hormone.

Abstract

Glucose utilization and secretion of insulin and growth hormone after intravenous administration of glucose were measured during the evolution of myocardial infarctions. Two patterns of responses were found. Patients who developed myocardial infarction with either no prior cardiovascular disease or stable coronary artery disease had depressed glucose utilization for the first 48 hours and exhibited a hyperinsulinemic response to glucose during the sixth to fourteenth day; and, about 50% of them, had an increase in the secretion of growth hormone during the initial 4 days of the infarction. Patients who had had progressively increasing angina in the 7 to 14 days preceding infarction showed a different pattern. No initial depression of glucose utilization was found. Their hyperinsulinemic response occurred within the first 96 hours of the occlusion. Growth hormone secretion was increased in 83% of the patients during the first 96 hours. The data suggest the possibility that the exaggerated insulin secretion may be associated with myocardial repair processes while the changes in growth hormone secretion may be related to the acute stress or necrosis of the infarction.