Wambolt R B, Grist M, Bondy G P, Allard M F
McDonald Research Laboratories/iCapture Center, Department of Pathology and Laboratory Medicine, University of British Columbia, St Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.
Can J Cardiol. 2001 Aug;17(8):889-94.
After ischemia, glycolysis and dysfunction are greater, while coupling of glucose oxidation to glycolysis is lower in hypertrophied hearts than in nonhypertrophied hearts.
To test the hypothesis that accelerated glycolysis, reduced coupling of glucose oxidation to glycolysis and increased postischemic dysfunction in hypertrophied hearts compared with nonhypertrophied hearts occur in the absence of differences in coronary flow.
Function, glycolysis and glucose oxidation were measured in isolated working control and hypertrophied rat hearts studied for 30 min before, and for 40 min after no flow global ischemia for 20 min under conditions in which coronary flow was comparable between the two groups. The hearts were perfused with 1.2 mmol/L palmitate, 5.5 mmol/L [5-3H/U-14C]-glucose, 0.5 mmol/L lactate, 100 mU/L insulin at a preload of 11.5 mmHg, and an afterload of 60 mmHg in control hearts or 80 mmHg in hypertrophied hearts.
Despite comparable rates of coronary flow, functional recovery was lower in hypertrophied hearts than in control hearts. The rates of glycolysis were accelerated in hypertrophied hearts, while glucose oxidation did not significantly differ between the two groups. As a result, the coupling of glucose oxidation to glycolysis was lower in hypertrophied hearts than in control hearts.
Increased postischemic dysfunction, accelerated glycolysis and reduced coupling of glucose oxidation to glycolysis in hypertrophied hearts compared with control hearts cannot be accounted for by differences in coronary flow. These data provide support for the concept that alterations in glucose metabolism contribute to the exaggerated postischemic dysfunction of hypertrophied hearts.
缺血后,肥厚心肌中的糖酵解和功能障碍更严重,而与非肥厚心肌相比,葡萄糖氧化与糖酵解的偶联更低。
验证如下假说:与非肥厚心肌相比,肥厚心肌在冠状动脉血流无差异的情况下,会出现糖酵解加速、葡萄糖氧化与糖酵解的偶联降低以及缺血后功能障碍增加。
在两组冠状动脉血流相当的条件下,对分离的正常工作的对照大鼠心脏和肥厚大鼠心脏进行检测。在无血流全心缺血20分钟之前30分钟以及之后40分钟,测量其功能、糖酵解和葡萄糖氧化情况。心脏灌注1.2 mmol/L棕榈酸、5.5 mmol/L [5-³H/U-¹⁴C] -葡萄糖、0.5 mmol/L乳酸、100 mU/L胰岛素,对照心脏的前负荷为11.5 mmHg,后负荷为60 mmHg,肥厚心脏的后负荷为80 mmHg。
尽管冠状动脉血流速率相当,但肥厚心脏的功能恢复低于对照心脏。肥厚心脏的糖酵解速率加快,而两组之间葡萄糖氧化无显著差异。因此,肥厚心脏中葡萄糖氧化与糖酵解的偶联低于对照心脏。
与对照心脏相比,肥厚心脏缺血后功能障碍增加、糖酵解加速以及葡萄糖氧化与糖酵解的偶联降低,不能用冠状动脉血流差异来解释。这些数据支持了葡萄糖代谢改变导致肥厚心脏缺血后功能障碍加剧这一概念。