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Myocardial Failure pp 275–290Cite as

Metabolic Heart Disease With Special Reference to Carbohydrate Metabolism in Health and Disease

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Part of the book series: International Boehringer Mannheim Symposia ((BOEHRINGER))

Abstract

The pioneering studies of Bing (3) showed the usefulness of measurements of arteriovenous differences across the human heart to define normal substrate metabolism (34). In the resting, fasted state, the uptake of glucose could, if fully oxidized, account for 30% of the concomitant oxygen uptake; lactate could account for 10% and free fatty acids for 60% (Table 1). But after a light, low-fat breakfast, the increased uptake of glucose accounts for 68% and that of lactate for 28% cf the oxygen uptake (14). Thus the balance between carbohydrate and lipid substrates is altered by the nutritional state of the body (37). In the fasted state, high circulating free fatty acids (FFA) and low insulin levels lead to increased uptake of FFA by the heart, whereas high insulin and low FFA after a low-fat meal lead to increased glucose uptake. How does the heart regulate these switches between predominant use of carbohydrate or of lipid as major fuel?

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References

  1. Allison, T. B., Bruttig, M. F., Crass, M. F. III., Shipp, J. C.: Reduced high-energy phosphate levels in rat hearts. 1. Effects of alloxan diabetes. Amer. J. Physiol. 230, 1744–1750 (1976)

    PubMed  CAS  Google Scholar 

  2. Armiger, L. C., Herdson, P. B., Gavin, J. B. Mitochondrial changes in dog myocardium induced by lowered pH in vitro. Lab. Invest. 32, 223–226 (1975)

    PubMed  CAS  Google Scholar 

  3. Bing R.J.: Cardiac metabolism. Physiol. Rev. 45, 171–213 (1965)

    PubMed  CAS  Google Scholar 

  4. Bing, O. H. L., Brooks, W. W., Messer, J. V.: Heart muscle viability following hypoxia: protective effect of acidosis. Science 180, 1297–1298 (1973)

    Article  PubMed  CAS  Google Scholar 

  5. Borrebaek, B., Christiansen, R., Christophersen, B. O., Bremer, J.: The role of acyltransferases in fatty acid utilization. Circulat. Res. 38, Suppl. 1, 16–20 (1976)

    Google Scholar 

  6. Bricknell, O. L., Opie, L. H.: Glycolytic ATP and its production during ischaemia in isolated Langendorff-perfused rat hearts. Recent Advanc. Stud. Cardiac Struct. Metab. In press

    Google Scholar 

  7. Büdingen, T.: Über die Möglichkeit einer Ernährungsbehandlung des Herzmuskels durch Einbringen von Traubenzuckerlösungen in den grossen Kreislauf. Dtsch. Arch. klin. Med. 114, 534–579 (1914)

    Google Scholar 

  8. Carlson, L. A., Kaijser, L., Lassers, B. W.: Myocardial metabolism of plasma triglycerides in man. J. molec. cell. Cardiol. 1, 467–475 (1970)

    Article  CAS  Google Scholar 

  9. De Leiris, J., Feuvray, D.: Ischaemia-induced damage in the working rat heart preparation. The effect of perfusate substrate composition on subendocardial ultrastructure of the ischaemic left ventricular wall. J. molec. cell. Cardiol. In press (1976)

    Google Scholar 

  10. De Leiris, J., Lubbe, W. F., Opie, L. H.: Effects of free fatty acid and glucose on enzyme release in experimental myocardial infarction. Nature (Lond.) 253, 746–747 (1975)

    Article  Google Scholar 

  11. Denton, R. M., Randle, P. J.: Concentrations of glycerides and phospholipids in rat heart and gastrocnemius muscles. Effects of alloxan-diabetes and perfusion. Biochem. J. 104, 416–422 (1967)

    PubMed  CAS  Google Scholar 

  12. Evans, J. R., Opie, L. H., Shipp, J. C.: Metabolism of palmitic acid in perfused rat heart. Amer. J. Physiol. 205, 766–770 (1964)

    Google Scholar 

  13. Garfinkel, D.: Lactate permeation. Circul. Res. 38, Suppl. 1, 1315 (1976)

    Google Scholar 

  14. Goodale, W. T., Olson, R. E., Hackel, D. B.: The effects of fasting and diabetes mellitus on myocardial metabolism in man. Amer. J. Med. 27, 212–220 (1959)

    Article  PubMed  CAS  Google Scholar 

  15. Hoak, J. C., Poole, J. C. F., Robinson, D. S.: Thrombosis associated with mobilization of fatty acids. Amer. J. Path. 43, 987–998 (1963)

    PubMed  CAS  Google Scholar 

  16. Kurien, V. A., Oliver, M. F.: A metabolic cause for arrhythmias during acute myocardial hypoxia. Lancet 1, (1970) 813–815

    Article  PubMed  CAS  Google Scholar 

  17. Kurien, V. A., Yates, P. A., Oliver, M. F.: The role of free fatty acids in the production of ventricular arrhythmias after acute coronary artery occlusion. Europ. J. clin. Invest. 1, 225–241 (1971)

    PubMed  CAS  Google Scholar 

  18. Lancet Editorial: Free fatty acids and arrhythmias after myocardial infarction. Lancet (1975) 1, 313–314

    Google Scholar 

  19. Lochner, A., Kotzé, J. C. N., Gevers, W.: Mitochondrial oxidative phosphorylation in myocardial ischaemia: Effects of glycerol, glucose and insulin on anoxic hearts perfused at low pressure. J. molec. cell. Cardiol. 8, 575–584 (1976)

    Article  CAS  Google Scholar 

  20. Madias, J. E., Madias, N. E., Hood, W. B. Jr.: Precordial ST-segment mapping. 2. Effects of oxygen inhalation on ischaemic injury in patients with acute myocardial infarction. Circulation 53, 411–417 (1976)

    PubMed  CAS  Google Scholar 

  21. Mansour, T. E. Studies on heart phosphofructokinase: purification, inhibition and activation. J. biol. Chem. 238, 2285–2292 (1963)

    CAS  Google Scholar 

  22. Maroko, P. R., Kjekshus, J. K., Sobel, B. E., Watanabe, T., Covell, J. W., Ross, J. Jr., Braunwald, E.: Factors influencing infarct size following experimental coronary artery occlusions. Circulation, 43, 67–82 (1971)

    PubMed  CAS  Google Scholar 

  23. Maroko, P. R., Libby, P., Sobel, B. E., Bloor, C. M., Sybers, H. D., Shell, W. E., Covell, J. W., Braunwald, E.: Effect of glucose-insulin-potassium infusion on myocardial infarction following experimental coronary artery occlusion. Circulation 45, 1160–1175 (1972)

    PubMed  CAS  Google Scholar 

  24. Maroko, P. R., Radvany, P., Braunwald, E., Hale, S. L.: Reduction of infarct size by oxygen inhalation following acute coronary occlusion. Circulation 52, 360–368 (1975)

    PubMed  CAS  Google Scholar 

  25. Miller, N. E., Mjos, O. D., Oliver, M. F.: Relationship of epicardial ST segment elevation to the plasma free fatty acid/albumin ratio during coronary occlusion in dogs. Clin. Sci. molec. Med. 51, 209–213 (1976)

    CAS  Google Scholar 

  26. Mjos, O.D., Miller, N. E., Riemersma, R. A., Oliver, M. F.: Effects of dichloroacetate on myocardial substrate extraction, epicardial ST-segment elevation, and ventricular blood flow following coronary occlusion in dogs. Cardiovasc. Res. 10, 427–436 (1976a)

    Article  PubMed  CAS  Google Scholar 

  27. Mjos, O. D., Miller, N. E., Riemersma, R. A., Oliver, M. F.: Effects of p-chlorophenoxysobutyrate on myocardial free fatty acid extraction blood flow, and epicardial ST-segment elevation during coronary occlusion in dogs. Circulation 53, 494–500 (1976b)

    PubMed  CAS  Google Scholar 

  28. Neely, J. R., Whitmer, K. M., Mochizuki, S.: Effects of mechanical, activity and hormones on myocardial glucose and fatty acid utilization. Circulat. Res. 38, Suppl. 1 22–29 (1976)

    Google Scholar 

  29. Newsholme, E. A., Randle, P. J.: Regulation of glucose uptake by muscle. 7. Effects of fatty acids, ketone bodies and pyruvate, and of alloxan-diabetes, starvation, hypophysectomy and adrenalectomy on the concentrations of hexose phosphate, nucleotides and inorganic phosphate in perfused rat heart. Biochem. J. 93, 641–651 (1964)

    PubMed  CAS  Google Scholar 

  30. Oliver, M. F.: Metabolic response during impending myocardial infarction. II. Clinical implication. Circulation 45, 491–500 (1972)

    PubMed  CAS  Google Scholar 

  31. Oliver, M. F., Kurien, V. A., Greenwood, T. W.: Relation between serum free fatty acids and arrhythmias and death after acute myocardial infarction. Lancet (1968) 1, 710–715

    Article  PubMed  CAS  Google Scholar 

  32. Oliver, M. F., Rowe, M. J., Luxton, M. R., Miller, N. E., Neilson, J. M.: Effect of reducing circulating free fatty acids on ventricular arrhythmias during myocardial infarction and on ST-segment depression during exercise-induced ischaemia. Circulation 53, 1–210 (1976)

    Google Scholar 

  33. Opie, L. H.: Metabolism of the heart in health and disease. Part I. Amer. Heart J. 76, 685–698 (1968)

    Article  PubMed  CAS  Google Scholar 

  34. Opie, L. H.: Metabolism of the heart in health and disease. Part II. Amer. Heart J. 77, 100–122 (1969)

    Article  PubMed  CAS  Google Scholar 

  35. Opie, L. H. The glucose hypothesis: Relation to acute myocardial ischaemia. J. molec. cell. Cardiol. 1, 107–116 (1970)

    Article  Google Scholar 

  36. Opie, L. H. Substrate utilization and gl ycolysis in the heart. Cardiology 56, 2–21 (1971/72)

    Google Scholar 

  37. Opie, L. H.: Metabolic response during impending myocardial infarction. 1. Relevance of studies of glucose and fatty acid metabolism in animals. Circulation 45, 483–490 (1972)

    PubMed  CAS  Google Scholar 

  38. Opie, L. H.: Metabolism of free fatty acids, glucose and catecholamines in acute myocardial infarction. Amer. J. Cardiol. 36, 938–953 (1975)

    Article  PubMed  CAS  Google Scholar 

  39. Opie, L. H.: Effects of anoxia and regional ischaemia on metabolism of glucose and fatty acids. Relative rates of aerobic and anaerobic energy production during first 6 hours of experimental myocardial infarction. Circulat. Res. 38, Suppl. 1, 152–168 (1976)

    Google Scholar 

  40. Opie, L. H., Bruyneel, K., Owen, P.: Effects of glucose, potassium and insulin infusion on tissue metabolic changes within first hour of myocardial infarction in the baboon. Circulation 52, 49–57 (1975)

    PubMed  CAS  Google Scholar 

  41. Opie, L. H., Mansford, K. R. L.: The value of lactate and pyruvate measurements in the assessment of the redox state of free nicotinamide-adenine dinucleotide in the cytoplasm of perfused rat heart. Europ. J. clin. Invest. 1, 295–306 (1971)

    PubMed  CAS  Google Scholar 

  42. Opie, L. H., Norris, R. N., Thomas, M., Holland, A. J., Owen, P., Van Noorden, S.: Failure of high concentrations of circulating free fatty acids to provoke arrhythmias in experimental myocardial infarction. Lancet (1971) 1, 818–822

    Article  PubMed  CAS  Google Scholar 

  43. Opie, L. H., Owen, P.: Effect of glucose-insulin-potassium infusions on arteriovenous differences of glucose and of free fatty acids and on tissue metabolic changes in dogs with developing myocardial infarction. Amer. J. Cardiol. In press (1976)

    Google Scholar 

  44. Opie, L. H., Owen, P., Riemersma, R. A.: Relative rates of oxidation of glucose and free fatty acids by ischaemic and non-ischaemic myocardium after coronary artery ligation in the dog. Europ. J. clin. Invest. 3, 419–435 (1973)

    Article  PubMed  CAS  Google Scholar 

  45. Opie, L. H., Thomas, M.: Propranolol and experimental myocardial infarction: substrate effects. Postgrad. med. J. 52, Suppl. 4, 124–132 (1976)

    Google Scholar 

  46. Owen, P., Thomas, M., Young, V., Opie, L.: Comparison between metabolic changes in local venous and coronary sinus blood after acute experimental coronary arterial occlusion. Amer. J. Cardiol. 25, 562–570 (1970)

    Article  PubMed  CAS  Google Scholar 

  47. Pelides, L. J., Reid, D. S., Thomas, M., Shillingford, J. P.: Inhibition by 13-blockade of the ST segment elevation after acute myocardial infarction in man. Cardiovasc. Res. 6, 295–301 (1972)

    Article  PubMed  CAS  Google Scholar 

  48. Randle, P. J.: Regulation of glycolysis and pyruvate oxidation in cardiac muscle. Circulat. Res. 38, Suppl. 1, 8–12 (1976)

    Google Scholar 

  49. Regan, T. J., Effros, R. M., Haider, B., Oldenwurtel, H. A., Ettinger, P. O., Ahmed, S. S.: Myocardial ischaemia and cell acidosis: Modification by alkali and the effects on ventricular function and cation composition. Amer. J. Cardiol. 37, 501–507 (1976)

    Article  PubMed  CAS  Google Scholar 

  50. Regan, T. J., Ettinger, P. O., Philip, O., Khan, M., Mohan, U. J., Lyons, M., Oldewurtel, H., Weber, M.: Altered myocardial function and metabolism in chronic diabetes mellitus without ischaemia in dogs. Circulat. Res. 35, 222–237 (1974)

    CAS  Google Scholar 

  51. Regan, T. J., Koroxenidis, G., Moschos, C. B., Oldewurtel, H. A., Lehan, P. H., Hellems, H. K.: The acute metabolic and hemodynamic response of the left ventricle to ethanol. J. clin. Invest. 45, 270–280 (1966)

    Article  PubMed  CAS  Google Scholar 

  52. Regan, T. J., Moschos, C. B., Lehan, P. H., Oldewurtel, H. A., Hellems, H. K.: Lipid and carbohydrate metabolism of myocardium during the biphasic inotropic response to epinephrine. Circulat. Res. 19, 307–316 (1966)

    PubMed  CAS  Google Scholar 

  53. Regen, D. M., Davis, W. W., Morgan, H. E., Park, C. P.: The regulation of hexokinase and phosphofructokinase activity in heart muscle. Effects of alloxan diabetes, growth hormone, cortisol and anocia. J. biol. Chem. 239, 43–49 (1964)

    PubMed  CAS  Google Scholar 

  54. Reimer, K. A., Rasmussen, M. M., Jennings, R. B.: Reduction by propranolol of myocardial necrosis following temporary coronary artery occlusion in dogs. Circul. Res. 33, 353–363 (1973)

    CAS  Google Scholar 

  55. Rovetto, M. J., Lamberton, W. F., Neely, J. R.: Mechanisms of glycolytic inhibition in ischaemic rat hearts. Circulat. Res. 37, 742–751 (1975)

    PubMed  CAS  Google Scholar 

  56. Scheuer, J., Stezoski, W. S.: The effect of alkalosis upon the mechanical and metabolic response of the rat heart to hypoxia. J. molec. cell. Cardiol. 4, 599–610 (1972)

    Article  CAS  Google Scholar 

  57. Shipp, J. C., Menahan, L. A., Crass, M. F. III., Chaudhuri, S. N.: Heart triglycerides in health and disease. Recent Advanc. Stud. Cardiac Struct. Metab. 3, 179–204 (1973)

    CAS  Google Scholar 

  58. Shug, A. L., Shrago, E., Bittar, N., Folts, J. D., Kokes, J. R.: Long chain fatty acyl CoA inhibition of adenine nucleotide translocase in the ischaemic myocardium. Amer. J. Physiol. 228, 689–692 (1975)

    PubMed  CAS  Google Scholar 

  59. Sinclair-Smith, B., Opie, L. H.: Enzyme release in coronary ligated diabetic rat heart. In preparation (1976)

    Google Scholar 

  60. Smith, H. J., Singh, B. N., Nisbet, H. D., Morris, R. M.: Effects of verapamil on infarct size following experimental coronary occlusion. Cardiovasc. Res. 9, 569–578 (1975)

    Article  PubMed  CAS  Google Scholar 

  61. Spector, A.: Metabolism of free fatty acids. Progr. biochem. Pharmacol. 6, 130–176 (1971)

    CAS  Google Scholar 

  62. Sugden, P. H., Newsholme, E. A.: The effects of ammonium, inorganic phosphate and potassium ions on the activity of phosphofructokinases from muscle and nervous tissue of vertebrates and invertebrates. Biochem. J. 150, 113–122 (1975)

    PubMed  CAS  Google Scholar 

  63. Ui, M.: A role of phosphofructokinase in pH-dependent regulation of glycolysis. Biochim. biophys. Acta 124, 310–322 (1966)

    Article  PubMed  CAS  Google Scholar 

  64. Uyeda, K., Racker, E.: Regulatory mechanisms in carbohydrate metabolism. 7. Hexokinase and phosphofructokinase. J. biol. Chem. 240, 4682–4688 (1965)

    PubMed  CAS  Google Scholar 

  65. Wissner, S. B.: The effect of excess lactate upon the excitability of the sheep Purkinje fiber. J. Electrocardiol. 7, 17–26 (1974)

    Article  PubMed  CAS  Google Scholar 

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  1. L. H. Opie
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Editors and Affiliations

  1. Medizinische Klinik I, Klinikum Großhadern, Marchioninistraße 15, D-8000, München 70, Germany

    G. Riecker , H.-D. Bolte , B. Lüderitz , B. E. Strauer  & E. Erdmann , , ,  & 

  2. School of Medicine, Department of Biochemistry, University of Pennsylvania, 19174, Philadelphia, PA, USA

    A. Weber M.D., Ph.D.

  3. Hammersmith Hospital, Royal Postgraduate Medical School, University of London, Ducane Road, London W12, England

    J. F. Goodwin M.D., F.R.C.P.

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Opie, L.H. (1977). Metabolic Heart Disease With Special Reference to Carbohydrate Metabolism in Health and Disease. In: Riecker, G., et al. Myocardial Failure. International Boehringer Mannheim Symposia. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-46352-5_28

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  • DOI: https://doi.org/10.1007/978-3-642-46352-5_28

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