Reed M K, Barak C, Malloy C R, Maniscalco S P, Jessen M E
Department of Surgery, University of Texas Southwestern Medical Center at Dallas 75235-8879, USA.
J Thorac Cardiovasc Surg. 1996 Dec;112(6):1651-60. doi: 10.1016/S0022-5223(96)70024-7.
A recent report (J Clin Invest 1993;92:831-9) found no effect of glutamate plus aspartate on metabolic pathways in the heart, but the experimental conditions did not model clinical cardioplegia. The purpose of this study was to determine the effects of glutamate and aspartate on metabolic pathways feeding the citric acid cycle during cardioplegic arrest in the presence of physiologic substrates.
Isolated rat hearts were supplied with fatty acids, lactate, pyruvate, glucose, and acetoacetate in physiologic concentrations. These substrates were enriched with 13C, which allowed a complete analysis of substrate oxidation by 13C-nuclear magnetic resonance spectroscopy in one experiment. Three groups of hearts were studied: arrest with potassium cardioplegic solution, arrest with cardioplegic solution supplemented with glutamate and aspartate (both in concentrations of 13 mmol/L), and a control group without cardioplegic arrest.
In potassium-arrested hearts, the contributions of fatty acids and lactate to acetyl coenzyme A were reduced, and acetoacetate was the preferred substrate for oxidation in the citric acid cycle. The addition of aspartate and glutamate in the presence of cardioplegic arrest did not further alter patterns of substrate utilization substantially, although acetoacetate use was somewhat lower than with simple cardioplegic arrest. When [U-13C]glutamate (13 mmol/L) and [U-13C]aspartate (13 mmol/L) were supplied as the only compounds labeled with 13C, little enrichment in citric acid cycle intermediates could be detected.
Glutamate and aspartate when added to potassium cardioplegic solutions have relatively minor effects on citric acid cycle metabolism.
最近一项报告(《临床研究杂志》1993年;92:831 - 9)发现谷氨酸加天冬氨酸对心脏代谢途径无影响,但实验条件并非模拟临床心脏停搏。本研究的目的是确定在存在生理底物的情况下,谷氨酸和天冬氨酸对心脏停搏期间为柠檬酸循环提供底物的代谢途径的影响。
给离体大鼠心脏提供生理浓度的脂肪酸、乳酸、丙酮酸、葡萄糖和乙酰乙酸。这些底物用13C进行富集,这使得在一个实验中通过13C核磁共振波谱法能够对底物氧化进行全面分析。研究了三组心脏:用钾心脏停搏液停搏、用添加了谷氨酸和天冬氨酸(浓度均为13 mmol/L)的心脏停搏液停搏以及无心脏停搏的对照组。
在钾停搏的心脏中,脂肪酸和乳酸对乙酰辅酶A的贡献降低,乙酰乙酸是柠檬酸循环中氧化的首选底物。在心脏停搏时添加天冬氨酸和谷氨酸并没有进一步显著改变底物利用模式,尽管乙酰乙酸的利用比单纯心脏停搏时略低。当以[U - 13C]谷氨酸(13 mmol/L)和[U - 13C]天冬氨酸(13 mmol/L)作为仅有的用13C标记的化合物提供时,在柠檬酸循环中间产物中几乎检测不到富集。
添加到钾心脏停搏液中的谷氨酸和天冬氨酸对柠檬酸循环代谢的影响相对较小。