Dong Shuohui, Qian Linhui, Cheng Zhiqiang, Chen Chang, Wang Kexin, Hu Sanyuan, Zhang Xiang, Wu Tongzhi
Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China.
Department of Colorectal and Anal Surgery, Feicheng Hospital Affiliated to Shandong First Medical University, Feicheng, China.
Front Physiol. 2021 Aug 17;12:715081. doi: 10.3389/fphys.2021.715081. eCollection 2021.
The myocardium is capable of utilizing different energy substrates, which is referred to as "metabolic flexibility." This process assures ATP production from fatty acids, glucose, lactate, amino acids, and ketones, in the face of varying metabolic contexts. In the normal physiological state, the oxidation of fatty acids contributes to approximately 60% of energy required, and the oxidation of other substrates provides the rest. The accumulation of lactate in ischemic and hypoxic tissues has traditionally be considered as a by-product, and of little utility. However, recent evidence suggests that lactate may represent an important fuel for the myocardium during exercise or myocadiac stress. This new paradigm drives increasing interest in understanding its role in cardiac metabolism under both physiological and pathological conditions. In recent years, blood lactate has been regarded as a signal of stress in cardiac disease, linking to prognosis in patients with myocardial ischemia or heart failure. In this review, we discuss the importance of lactate as an energy source and its relevance to the progression and management of heart diseases.
心肌能够利用不同的能量底物，这一过程被称为“代谢灵活性”。面对不同的代谢环境，该过程可确保从脂肪酸、葡萄糖、乳酸、氨基酸和酮类中产生三磷酸腺苷（ATP）。在正常生理状态下，脂肪酸氧化约占所需能量的60%，其他底物的氧化提供其余能量。传统上，缺血和缺氧组织中乳酸的积累被认为是一种副产品，几乎没有用处。然而，最近的证据表明，在运动或心肌应激期间，乳酸可能是心肌的重要燃料。这种新的范例激发了人们对了解其在生理和病理条件下心脏代谢中作用的越来越浓厚的兴趣。近年来，血乳酸一直被视为心脏病应激的一个信号，与心肌缺血或心力衰竭患者的预后相关。在这篇综述中，我们讨论了乳酸作为能量来源的重要性及其与心脏病进展和管理的相关性。
