Haemodynamic effects of glucagon

Murtagh, J G; Binnion, Peter F.; Lal, Sara; Hutchison, K.J.; Fletcher, E.

doi:10.1136/hrt.32.3.307

Cited by 51 publications

(20 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the use of glucagon in low cardiac output syndromes of acute onset is encouraging, its use in chronic congestive heart failure has met with variable success. 59,89,91,108,125,131 The previously discussed data of Gold and associates 38 may provide a more fundamental explanation for the disappointing results in treating chronic heart failure with glucagon.…”

Section: Resultsmentioning

confidence: 85%

“…1 When it occurs, decreased SVR has been postulated to be due to a direct effect and reflexly secondary to an increased CO, possibly mediated by lower adrenergic drive. 89 The direct action of glucagon to lower SVR has been contested by Murtagh and associates 89 when studying the effect of glucagon on forearm blood flow (seven patients) and calf blood flow (three patients) by venous occlusion plethysmography. However, in patients with depressed myocardial contractility in large part contributing to hypotension, an increase in contractility by glucagon may cause an increase in blood pressure (see section below for additional data in clinical trials).…”

Section: Clinical Pharmacologymentioning

confidence: 97%

See 1 more Smart Citation

Glucagon: Present status in cardiovascular disease

Kones

Phillips

1971

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

The actions of pancreatic glucagon, a known hyperglycemic, hypoaminoacidemic, and lipolytic agent, have received recent attention because of a variety of effects mediated by increases in cyclic AMP concentrations. Studies in the dog demonstrated the positive inotropic and chronotropic actions of glucagon, unaltered by reserpine, insulin, or propranolol. Enhanced contractility was additive with that of the digitalis preparations but did not produce undesirable arrhythmias. The ability of glucagon to increase contractility was attenuated with longer duration of experimental congestive heart failure, thus implying greater effectiveness in acute pathology. In man, variables dependent upon contractility are correspondingly enhanced with the use of glucagon. Current evidence suggests glucagon is a secondary coronary vasodilator and lowers renal vascular resistance as well. improvement have been noted as a result of continuous glucagon therapy in patients with early congestive heart failure, cardiogenic shock, myocardial infarction, and in low output syndromes following open heart surgery. Glucagon appears to activate adenyl cyclase to increase cycliC AMP levels, which in tum enlarges the intracellular calcium pool. Thus, according to current excitation-contraction theories, an increase in contractility results.Extracardiac and metabolic effects

show abstract

Section: Resultsmentioning

confidence: 85%

Section: Clinical Pharmacologymentioning

confidence: 97%

Glucagon: Present status in cardiovascular disease

Kones

Phillips

1971

Clin Pharma and Therapeutics

View full text Add to dashboard Cite

show abstract

“…We chose to control the heart rate and study the effects of glucagon 5 and 7 min following administration, as most observers have found a peak effect during this period [8,10,16]. Others [17], however, have found a maximum effect slightly later and it is possible that, with our protocol, we missed the peak action of the drug.…”

Section: Discussionmentioning

confidence: 99%

“…Its use in patients with cardiac failure following myocardial infarction has therefore been proposed [12,16]. Because the improvement in myocardial performance that has been demonstrated may be related to the increase in heart rate that usually occurs following the administration of this agent [14,24], we have tested the effects of glucagon when the heart rate was controlled by atrial pacing.…”

Section: Introductionmentioning

confidence: 99%

Effects of Glucagon on Left Ventricular Function in Man with Controlled Heart Rate

Smithen¹,

Balcon²,

Sowton³

1972

Cardiology

View full text Add to dashboard Cite

Five patients with aortic Starr-Edwards valves were studied during routine postoperative catheterization. The hemodynamic effects of 5 mg of intra venous glucagon were measured with and without atrial pacing to control the heart rate. Left ventricular function was assessed, using mean systolic ejection rate and the time taken for the ball of the prosthesis to cross the cage (ball travel time), which is closely related to maximum acceleration of blood into the ascending aorta. Heart rate rose by 22% and cardiac output by 14% when the atrium was not paced. With heart rate controlled, there was no significant change in cardiac output, mean systolic ejection rate or in ball travel time. A slight reduction in atrioventricular conduction time was observed. It is suggested that glucagon has no positive inotropic action in man independent of heart rate in these experimental conditions.

show abstract

“…This has been linked to the small elevation in glucagon levels (in the fasting state the increase in plasma glucagon levels ranges from 10% to 20% [8,9]), proposed to play a possible role in cardiovascular protection. While some experimental data support a cardioprotective effect of glucagon [10], only one study in humans, from more than four decades ago, demonstrated a benefit from glucagon infusion in patients with heart failure and cardiogenic shock [11]. SGLT2 inhibitor-induced stimulation of glucagon secretion with simultaneous decreases in insulin secretion favour lipolysis, which increases circulating concentrations of NEFA, requiring a greater amount of oxygen to generate the same amount of ATP compared with glucose [3].…”

mentioning

confidence: 99%