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Myocardial substrate utilization in anaphylactic shock.

J J Spitzer

    Proceedings of the Society for Experimental Biology and Medicine. Society for Experimental Biology and Medicine (New York, N.Y.)
    |January 1, 1976
    PubMed
    Summary
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    Anaphylactic shock alters heart muscle energy use, reducing fatty acid oxidation and increasing lactate use. These metabolic shifts in the heart mirror those seen after severe bleeding or endotoxin exposure.

    Area of Science:

    • Cardiovascular Physiology
    • Metabolic Research
    • Immunology

    Background:

    • Anaphylactic shock is a severe allergic reaction with significant hemodynamic compromise.
    • Understanding myocardial substrate utilization is crucial for managing shock states.
    • Previous research indicates metabolic changes occur during shock, but specific cardiac substrate shifts in anaphylaxis are less defined.

    Purpose of the Study:

    • To investigate alterations in myocardial substrate utilization during experimentally induced anaphylactic shock.
    • To compare these metabolic changes to those observed in other shock models.

    Main Methods:

    • Anesthetized dogs were subjected to anaphylactic shock.
    • Hemodynamic parameters (mean arterial blood pressure, cardiac output) and blood pH were monitored.

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  • Myocardial substrate utilization, specifically free fatty acid (FFA) oxidation and lactate uptake, was assessed.

    • Main Results:

    • Anaphylactic shock led to significant decreases in mean arterial blood pressure, cardiac output, and pH.
    • Myocardial FFA oxidation was markedly reduced, particularly within the first hour post-challenge.
    • Lactate uptake by the myocardium more than doubled during the same period.

    Conclusions:

    • Myocardial substrate utilization shifts away from free fatty acids (FFA) towards lactate during anaphylactic shock.
    • These metabolic changes in the heart during anaphylaxis are comparable to those seen after acute hemorrhage or E. coli endotoxin administration.
    • The heart adapts its energy source during anaphylactic shock, prioritizing lactate over FFA.