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Normothermic Ex Situ Heart Perfusion in Working Mode: Assessment of Cardiac Function and Metabolism
Published on: January 12, 2019
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Normalisation of diabetic heart pump function at decreased functional load.
V L Lakomkin1, A A Abramov1, E V Lukoshkova1
1National Medical Research Center of Cardiology.
Kardiologiia
|April 13, 2022
Summary
Diabetic rats with type 1 diabetes showed impaired heart function and energy metabolism. Reduced workload normalized pump function despite metabolic disturbances, highlighting the impact of functional load on diabetic cardiomyopathy.
Area of Science:
- Cardiovascular Physiology
- Metabolic Disorders
- Diabetic Complications
Background:
- Diabetic cardiomyopathy impairs heart contractility and shifts energy metabolism to fatty acids.
- This shift reduces energy efficiency and increases heart vulnerability to hypoxia.
- Type 1 diabetes mellitus (T1DM) is a significant risk factor for cardiovascular disease.
Purpose of the Study:
- To investigate left ventricular (LV) hemodynamics in diabetic rats with reduced cardiac blood inflow.
- To analyze changes in myocardial energy metabolites in the context of diabetes.
- To understand the interplay between hemodynamics, energy metabolism, and cardiac function in T1DM.
Main Methods:
- Type 1 diabetes was induced in rats using streptozotocin (60 mg/kg).
- Left ventricular (LV) pressure and volume were measured using a catheter-based system.
- Myocardial energy metabolites (ATP, creatine phosphate, lactate) were quantified.
Main Results:
- Diabetic rats exhibited a sixfold increase in blood glucose and signs of heart failure, including reduced ejection fraction (27%), minute volume (39%), and stroke work (41%).
- Systolic dysfunction was evident, with LV peak ejection velocity decreasing by over 50%. Increased arterial stiffness (1.5x) hampered ejection.
- Myocardial ATP and creatine phosphate decreased, while lactate increased threefold, indicating aerobic glycolysis. Reduced preload normalized cardiac pump function despite metabolic changes.
Conclusions:
- In T1DM, reduced functional load and oxygen consumption can normalize myocardial pump function.
- Disturbed myocardial energy metabolism persists even when cardiac function appears normalized under reduced load.
- These findings suggest that functional load is a critical determinant of cardiac performance in diabetic cardiomyopathy.
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