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Metabolismo del lactato miocárdico en corderos fetales y recién nacidos
B Bartelds1, H Knoester, G C Beaufort-Krol
1Division of Pediatric Cardiology, Department of Pediatrics, Beatrix Children's Hospital and Groningen Utrecht Institute for Drug Exploration, Groningen, Netherlands.
Circulation
|April 13, 1999
Resumen
El lactato es una fuente de energía clave para los corazones de cordero fetales y recién nacidos, con absorción y liberación que ocurren simultáneamente. Los ácidos grasos pueden reducir la oxidación del lactato en el miocardio del recién nacido.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- Metabolismo del recién nacido.
- Utilización del sustrato de energía cardíaca.
Sus antecedentes:
- El suministro de sustrato del miocardio cambia de carbohidratos a ácidos grasos alrededor del nacimiento.
- Se espera que el corazón haga la transición del lactato a la utilización de ácidos grasos después del parto.
- No existen mediciones in vivo del metabolismo del lactato miocárdico alrededor del nacimiento.
Objetivo del estudio:
- Para cuantificar la absorción, oxidación y liberación de lactato miocárdico en corderos fetales y recién nacidos.
- Investigar el impacto de los ácidos grasos y la glucosa en el metabolismo del lactato.
- Para entender la utilización del sustrato de energía cardíaca durante la transición perinatal.
Principales métodos:
- Utilizados crónicamente instrumentados corderos fetales y recién nacidos.
- Lactato [1-13C] infundido para medir la cinética del lactato miocárdico.
- Se evaluó el flujo de ácido graso miocárdico y el flujo de glucosa simultáneamente.
Principales resultados:
- Las tasas de oxidación del lactato miocárdico fueron similares en corderos fetales y recién nacidos.
- La absorción de lactato fue consistente entre corderos fetales y recién nacidos, superando la liberación.
- La absorción de lactato disminuyó con la edad en los recién nacidos y se correlacionó con el suministro; la oxidación no se vio afectada por el suministro de sustrato, pero estaba inversamente relacionada con el flujo de ácidos grasos.
Conclusiones:
- El lactato sirve como una importante fuente de energía miocárdica tanto en el prenatal como en el postnatal temprano.
- El miocardio exhibe absorción y liberación simultáneas de lactato.
- Los ácidos grasos, no la glucosa, pueden atenuar la oxidación del lactato, potencialmente a través de la piruvato deshidrogenasa.
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