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Cardiac Metabolic Protection for the Newborn Heart

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Cardiac Energy Metabolism in Health and Disease

Part of the book series: Advances in Biochemistry in Health and Disease ((ABHD,volume 11))

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Abstract

As the newborn heart transitions into the extrauterine environment, it emerges from a relatively hypoxic state, restricted predominately to glucose for energy, into an oxygen abundant environment in which a wider selection of substrates is available. Exposed to the unique milieu in utero, the fetal cardiac myocyte developed metabolic pathways that will subsequently adapt to postnatal life. Prior to the transition to a more adult-like metabolism, the newborn heart can take advantage of the metabolic profile developed in utero to protect itself during times of stress such as global ischemia and abrupt hypoxia. This relative tolerance to low oxygen levels and robust coronary perfusion of the neonatal heart have been exploited by surgeons to allow prolonged periods of bypass or cardiac arrest, facilitating repair of complex congenital heart defects. The ability of the newborn heart to utilize a variety of energy substrates has generated great interest in defining the optimal composition of cardioplegia solutions to enhance the ability of newborn myocardium to tolerate open heart surgery.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Wisconsin, 600 Highland Avenue, Madison, WI, 53792, USA

    J. Carter Ralphe M.D.

  2. Department of Pediatrics, University of Iowa, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Thomas D. Scholz M.D.

Authors
  1. J. Carter Ralphe M.D.
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  2. Thomas D. Scholz M.D.
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Corresponding author

Correspondence to Thomas D. Scholz M.D. .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada

    Gary D. Lopaschuk

  2. University of Manitoba, Institute of Cardiovascular Sciences, St. Boniface Hospital Research, Winnipeg, Manitoba, Canada

    Naranjan S. Dhalla

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Ralphe, J.C., Scholz, T.D. (2014). Cardiac Metabolic Protection for the Newborn Heart. In: Lopaschuk, G., Dhalla, N. (eds) Cardiac Energy Metabolism in Health and Disease. Advances in Biochemistry in Health and Disease, vol 11. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1227-8_17

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