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Myocardial lactate extraction: multi-determined metabolic function

E W Gertz, J A Wisneski, R Neese

    Circulation
    |February 1, 1980
    PubMed
    Summary

    Myocardial lactate extraction, a marker for heart ischemia, is influenced by various metabolic factors. A threshold of less than 10% extraction does not definitively indicate abnormal heart metabolism in healthy individuals.

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    Area of Science:

    • Cardiology
    • Human Physiology
    • Metabolic Research

    Background:

    • Myocardial lactate production signifies anaerobic metabolism due to hypoxia or anoxia.
    • Clinically, myocardial lactate extraction below 10% is often interpreted as a sign of ischemia.

    Purpose of the Study:

    • To investigate myocardial lactate extraction in healthy individuals.
    • To determine the relationship between myocardial lactate extraction and metabolic parameters like free fatty acids and glucose.

    Main Methods:

    • Coronary sinus and arterial catheterization were performed on 16 healthy young male volunteers.
    • Blood samples were collected at rest and during induced tachycardia (twice resting heart rate) via pacing.
    • Measurements included lactate, free fatty acids, and glucose levels.

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    Main Results:

    • 44% of subjects exhibited lactate extraction below 10% at rest and/or during pacing.
    • No subjects demonstrated myocardial lactate production.
    • Lactate extraction correlated inversely with arterial free fatty acids and positively with arterial lactate levels, but not with arterial glucose.

    Conclusions:

    • Myocardial lactate extraction is influenced by multiple metabolic factors.
    • An absolute value of lactate extraction below 10% in the absence of production cannot be definitively considered abnormal in healthy individuals.