This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gertz, E. W. Articles by Hanlon, J. T. Search for Related Content PubMed PubMed Citation Articles by Gertz, E. W. Articles by Hanlon, J. T.

Circulation, Vol 63, 1273-1279, Copyright © 1981 by American Heart Association

ARTICLES

Myocardial lactate metabolism: evidence of lactate release during net chemical extraction in man

EW Gertz, JA Wisneski, R Neese, JD Bristow, GL Searle and JT Hanlon

Myocardial blood flow has been recognized to be heterogeneous in patients with coronary artery disease. Traditional arterial-coronary sinus sampling methods cannot demonstrate comparable heterogeneity of myocardial metabolism. In this study we used a tracer technique to investigate possible heterogeneity of myocardial lactate metabolism. Twenty-one patients with symptoms of ischemic heart disease were studied. We injected 14C-1-lactate intravenously as a constant infusion after a priming dose. Coronary sinus and arterial samples were obtained for chemical and radioisotopic analyses. At rest, myocardial lactate extraction by chemical analysis was 24.6 +/- 8.5% (mean +/- SD). By radioisotopic analysis, the lactate extraction was 41.0 +/- 10.2% (p less than 0.001). Thus, certain areas of the myocardium were releasing lactate despite global net extraction of lactate. In the 12 patients with significant left main or both left anterior descending (LAD) and left circumflex (LCX) lesions, the calculated amount of lactate released at rest was 0.136 +/- 0.045 mumol/ml of blood (mean +/- SD). In contrast, the amount released in the six patients with a significant lesion in only the LAD or LCX was 0.076 +/- 0.019 mumol/ml, and in the three patients without left coronary arterial lesions it was 0.039 +/- 0.004 mumol/ml. Using a tracer method, myocardial lactate metabolism was demonstrated to be heterogeneous at rest in patients with ischemic heart disease. A significant amount of lactate can be released by the myocardium at a time when chemical arterial-coronary sinus analysis indicates global myocardial extraction. The amount of lactate released appears to be related to the severity of the coronary artery disease.

This article has been cited by other articles:

				P. Herrero, C. S. Dence, A. R. Coggan, Z. Kisrieva-Ware, P. Eisenbeis, and R. J. Gropler L-3-11C-Lactate as a PET Tracer of Myocardial Lactate Metabolism: A Feasibility Study J. Nucl. Med., December 1, 2007; 48(12): 2046 - 2055. [Abstract] [Full Text] [PDF]

				D. Neglia, A. De Caterina, P. Marraccini, A. Natali, M. Ciardetti, C. Vecoli, A. Gastaldelli, D. Ciociaro, P. Pellegrini, R. Testa, et al. Impaired myocardial metabolic reserve and substrate selection flexibility during stress in patients with idiopathic dilated cardiomyopathy Am J Physiol Heart Circ Physiol, December 1, 2007; 293(6): H3270 - H3278. [Abstract] [Full Text] [PDF]

				D. J. C. Alders, R. N. Cornelussen, F. W. Prinzen, P. A. C. Specht, M. I. M. Noble, A. J. Drake-Holland, F. J. J. de Kanter, and J. H. G. M. van Beek Heart/Cardiac Muscle: Regional sympathetic denervation affects the relation between canine local myocardial blood flow and oxygen consumption Exp Physiol, May 1, 2007; 92(3): 541 - 548. [Abstract] [Full Text] [PDF]

				M K Sinha, J M Vazquez, R Calvino, D C Gaze, P O Collinson, and J C Kaski Effects of balloon occlusion during percutaneous coronary intervention on circulating Ischemia Modified Albumin and transmyocardial lactate extraction. Heart, December 1, 2006; 92(12): 1852 - 1853. [Full Text] [PDF]

				C. d'Agostino, V. Labinskyy, V. Lionetti, M. P. Chandler, B. Lei, K. Matsuo, M. Bellomo, X. Xu, T. H. Hintze, W. C. Stanley, et al. Altered cardiac metabolic phenotype after prolonged inhibition of NO synthesis in chronically instrumented dogs Am J Physiol Heart Circ Physiol, April 1, 2006; 290(4): H1721 - H1726. [Abstract] [Full Text] [PDF]

				W. C. Stanley, F. A. Recchia, and G. D. Lopaschuk Myocardial Substrate Metabolism in the Normal and Failing Heart Physiol Rev, July 1, 2005; 85(3): 1093 - 1129. [Abstract] [Full Text] [PDF]

				C. Kennergren, V. Mantovani, L. Strindberg, E. Berglin, A. Hamberger, and P. Lonnroth Myocardial interstitial glucose and lactate before, during, and after cardioplegic heart arrest Am J Physiol Endocrinol Metab, April 1, 2003; 284(4): E788 - E794. [Abstract] [Full Text] [PDF]

				F. A. Recchia, J. C. Osorio, M. P. Chandler, X. Xu, A. R. Panchal, G. D. Lopaschuk, T. H. Hintze, and W. C. Stanley Reduced synthesis of NO causes marked alterations in myocardial substrate metabolism in conscious dogs Am J Physiol Endocrinol Metab, January 1, 2002; 282(1): E197 - E206. [Abstract] [Full Text] [PDF]

				M. D. Crittenden Intraoperative metabolic monitoring of the heart: I. Clinical assessment of coronary sinus metabolites Ann. Thorac. Surg., December 1, 2001; 72(6): S2220 - 2226. [Abstract] [Full Text] [PDF]

				G. W. Goodwin, D. M. Cohen, and H. Taegtmeyer [5-3H]glucose overestimates glycolytic flux in isolated working rat heart: role of the pentose phosphate pathway Am J Physiol Endocrinol Metab, March 1, 2001; 280(3): E502 - E508. [Abstract] [Full Text] [PDF]

				P. H. McNulty Comparison of local and systemic effects of insulin on myocardial glucose extraction in ischemic heart disease Am J Physiol Heart Circ Physiol, March 1, 2000; 278(3): H741 - H747. [Abstract] [Full Text] [PDF]

				B. Bartelds, H. Knoester, G. C. M. Beaufort-Krol, G. B. Smid, J. Takens, W. G. Zijlstra, H. S. A. Heymans, and J. R. G. Kuipers Myocardial Lactate Metabolism in Fetal and Newborn Lambs Circulation, April 13, 1999; 99(14): 1892 - 1897. [Abstract] [Full Text] [PDF]

				G. A. Brooks, H. Dubouchaud, M. Brown, J. P. Sicurello, and C. E. Butz Role of mitochondrial lactate dehydrogenase and lactate oxidation in the intracellular lactate shuttle PNAS, February 2, 1999; 96(3): 1129 - 1134. [Abstract] [Full Text] [PDF]

				C. Depre, J.-L. J. Vanoverschelde, and H. Taegtmeyer Glucose for the Heart Circulation, February 2, 1999; 99(4): 578 - 588. [Full Text] [PDF]

				G. W. Goodwin, C. S. Taylor, and H. Taegtmeyer Regulation of Energy Metabolism of the Heart during Acute Increase in Heart Work J. Biol. Chem., November 6, 1998; 273(45): 29530 - 29539. [Abstract] [Full Text] [PDF]

				G. C. M. Beaufort-Krol, J. Takens, M. C. Molenkamp, G. B. Smid, K. J. Meuzelaar, W. G. Zijlstra, and J. R. G. Kuipers Increased myocardial lactate oxidation in lambs with aortopulmonary shunts at rest and during exercise Am J Physiol Heart Circ Physiol, November 1, 1998; 275(5): H1503 - H1512. [Abstract] [Full Text] [PDF]

				G. A. Brooks, E. E. Wolfel, G. E. Butterfield, A. Cymerman, A. C. Roberts, R. S. Mazzeo, and J. T. Reeves Poor relationship between arterial [lactate] and leg net release during exercise at 4,300 m altitude Am J Physiol Regulatory Integrative Comp Physiol, October 1, 1998; 275(4): R1192 - R1201. [Abstract] [Full Text] [PDF]

				B. Bartelds, J.-W. C. Gratama, H. Knoester, J. Takens, G. B. Smid, J. G. Aarnoudse, H. S. A. Heymans, and J. R. G. Kuipers Perinatal changes in myocardial supply and flux of fatty acids, carbohydrates, and ketone bodies in lambs Am J Physiol Heart Circ Physiol, June 1, 1998; 274(6): H1962 - H1969. [Abstract] [Full Text] [PDF]

				G. W. Goodwin, F. Ahmad, T. Doenst, and H. Taegtmeyer Energy provision from glycogen, glucose, and fatty acids on adrenergic stimulation of isolated working rat hearts Am J Physiol Heart Circ Physiol, April 1, 1998; 274(4): H1239 - H1247. [Abstract] [Full Text] [PDF]

				R. Svedjeholm, I. Vanhanen, E. Hakanson, P. O. Joachimsson, L. Jorfeldt, and L. Nilsson METABOLIC AND HEMODYNAMIC EFFECTS OF INTRAVENOUS GLUTAMATE INFUSION EARLY AFTER CORONARY OPERATIONS J. Thorac. Cardiovasc. Surg., December 1, 1996; 112(6): 1468 - 1477. [Abstract] [Full Text]

				S. L. Henning, R. B. Wambolt, B. O. Schonekess, G. D. Lopaschuk, and M. F. Allard Contribution of Glycogen to Aerobic Myocardial Glucose Utilization Circulation, April 15, 1996; 93(8): 1549 - 1555. [Abstract] [Full Text]

				G. W. Goodwin, J. R. Arteaga, and H. Taegtmeyer Glycogen Turnover in the Isolated Working Rat Heart J. Biol. Chem., April 21, 1995; 270(16): 9234 - 9240. [Abstract] [Full Text] [PDF]

				B. M. Massie, S. Schaefer, J. Garcia, M. D. McKirnan, G. G. Schwartz, J. A. Wisneski, M. W. Weiner, and F. C. White Myocardial High-Energy Phosphate and Substrate Metabolism in Swine With Moderate Left Ventricular Hypertrophy Circulation, March 15, 1995; 91(6): 1814 - 1823. [Abstract] [Full Text]

				M. P. Chandler, H. Huang, T. A. McElfresh, and W. C. Stanley Increased nonoxidative glycolysis despite continued fatty acid uptake during demand-induced myocardial ischemia Am J Physiol Heart Circ Physiol, May 1, 2002; 282(5): H1871 - H1878. [Abstract] [Full Text] [PDF]