{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:02:39Z","timestamp":1765040559321},"reference-count":30,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pisa University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p>Dilated cardiomyopathy (DCM) is characterized by a metabolic shift from fat to carbohydrates and failure to increase myocardial glucose uptake in response to workload increments. We verified whether this pattern is influenced by an abnormal glucose tolerance (AGT). In 10 patients with DCM, 5 with normal glucose tolerance (DCM-NGT) and 5 with AGT (DCM-AGT), and 5 non-DCM subjects with AGT (N-AGT), we measured coronary blood flow and arteriovenous differences of oxygen and metabolites during<jats:italic>Rest<\/jats:italic>,<jats:italic>Pacing<\/jats:italic>(at 130\u2009b\/min), and<jats:italic>Recovery<\/jats:italic>. Myocardial lactate exchange and oleate oxidation were also measured. At<jats:italic>Rest<\/jats:italic>, DCM patients showed a reduced nonesterified fatty acids (NEFA) myocardial uptake, while glucose utilization increased only in DCM-AGT. In response to<jats:italic>Pacing<\/jats:italic>, glucose uptake promptly rose in N-AGT (from 72 \u00b1 21 to 234 \u00b1 73\u2009nmol\/min\/g,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.05<\/mml:mn><\/mml:math>), did not change in DCM-AGT, and slowly increased in DCM-NGT. DCM-AGT sustained the extra workload by increasing NEFA oxidation (from 1.3 \u00b1 0.2 to 2.9 \u00b1 0.1\u2009<jats:italic>\u03bc<\/jats:italic>mol\/min\/gO<jats:sub>2<\/jats:sub>equivalents,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.05<\/mml:mn><\/mml:math>), while DCM-NGT showed a delayed increase in glucose uptake. Substrate oxidation rates paralleled the metabolites data. The presence of AGT in patients with DCM exacerbates both the shift from fat to carbohydrates in resting myocardial metabolism and the reduced myocardial metabolic flexibility in response to an increased workload. This trial is registered with ClinicalTrial.gov<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02440217\">NCT02440217<\/jats:ext-link>.<\/jats:p>","DOI":"10.1155\/2016\/3906425","type":"journal-article","created":{"date-parts":[[2015,12,21]],"date-time":"2015-12-21T21:00:53Z","timestamp":1450731653000},"page":"1-10","source":"Crossref","is-referenced-by-count":8,"title":["Abnormal Glucose Tolerance Is Associated with a Reduced Myocardial Metabolic Flexibility in Patients with Dilated Cardiomyopathy"],"prefix":"10.1155","volume":"2016","author":[{"given":"Domenico","family":"Tric\u00f2","sequence":"first","affiliation":[{"name":"Dipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, Italy"}]},{"given":"Simona","family":"Baldi","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, Italy"}]},{"given":"Silvia","family":"Frascerra","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, Italy"}]},{"given":"Elena","family":"Venturi","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, Italy"}]},{"given":"Paolo","family":"Marraccini","sequence":"additional","affiliation":[{"name":"National Research Council, Institute of Clinical Physiology, Pisa, Italy"}]},{"given":"Danilo","family":"Neglia","sequence":"additional","affiliation":[{"name":"National Research Council, Institute of Clinical Physiology, Pisa, Italy"}]},{"given":"Andrea","family":"Natali","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina Clinica e Sperimentale, Via Roma 67, 56126 Pisa, 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