Myocardial lactate extraction: multi-determined metabolic function

Myocardial lactate production indicates anaerobic metabolism resulting from hypoxia or anoxia. Clinically, myocardial lactate extraction of less than 10% has also been used as an indicator of ischemia. Sixteen healthy young male volunteers underwent coronary sinus and aterial catheterization. A coro...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1980-02, Vol.61 (2), p.256-261
Main Authors: Gertz, E W, Wisneski, J A, Neese, R, Houser, A, Korte, R, Bristow, J D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Blood Glucose
Fatty Acids, Nonesterified - blood
Heart - physiopathology
Heart Rate
Heparin - pharmacology
Humans
Hypoxia - metabolism
Lactates - blood
Lactates - metabolism
Male
Myocardium - metabolism
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Summary:Myocardial lactate production indicates anaerobic metabolism resulting from hypoxia or anoxia. Clinically, myocardial lactate extraction of less than 10% has also been used as an indicator of ischemia. Sixteen healthy young male volunteers underwent coronary sinus and aterial catheterization. A coronary sinus pacing catheter was used to obtain blood samples and increase the heart rate to twice the resting rate. Hemodynamic measurements and blood samples for lactate, free fatty acids and glucose were obtained at rest and during pacing. Seven of 16 sujects (44%) had lactate extraction of less than 10% at rest and/or at miximal pacing. No subject produced lactate. There was no correlation between myocardial lactate extraction and arterial glucose. However, lactate extraction correlated inversely with the arterial levels of free fatty acids (r = 0.67; p less than 0.01). In addition, a positive correlation was present between lactate extraction and the arterial lactate level (r = 0.78; p less than 0.01). In conclusion, myocardial lactate extraction is dependent on multiple metabolic parameters and any absolute value short of production cannot be considered abnormal.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.61.2.256