Myocardial Lactate Extraction: Multi‐determined Metabolic Function
Myocardial Lactate Extraction: Multi‐determined Metabolic Function
复制标题
心肌乳酸提取：多重确定的代谢功能
作者：
E. Gertz;J. Wisneski;R. Neese;A. Houser;R. Korte;J. Bristow
心肌乳酸盐的产生是由于缺氧引起的无氧代谢。临床上，心肌乳酸提取物低于10%也被用作缺血的指标。16名健康青年男性志愿者接受冠状静脉窦和动脉插管。使用冠状窦起搏导管采集血样，并将心率增加至静息心率的两倍。在静息和起搏期间获得血液动力学测量值和乳酸盐、游离脂肪酸和葡萄糖的血液样本。16例受试者中有7例（44%）在静息和/或最大起搏时乳酸提取率低于10%。无受试者产生乳酸。心肌乳酸提取率与动脉血糖无相关性。然而，乳酸提取与游离脂肪酸的动脉水平呈负相关（r =-0.67; p <0.01）。乳酸提取率与动脉血乳酸水平呈正相关（r = 0.78; P <0.01）。总之，心肌乳酸提取依赖于多种代谢参数，任何低于生产的绝对值都不能被认为是异常的。
SUMMARYMyocardial lactate production indicates anaerobic metabolism resulting from hypoxia or anoxia. Clinically, myocardial lactate extraction of less than 10% has also been used as an indicator of ischemia. Sixteen healthy young male volunteers underwent coronary sinus and arterial catheterization. A coronary sinus pacing catheter was used to obtain blood samples and increase the heart rate to twice the resting rate. Hemodynamic measurements and blood samples for lactate, free fatty acids and glucose were obtained at rest and during pacing. Seven of 16 subjects (44%) had lactate extraction of less than 10% at rest and/or at maximal pacing. No subject produced lactate. There was no correlation between myocardial lactate extraction and arterial glucose. However, lactate extraction correlated inversely with the arterial levels of free fatty acids (r = −0.67; p < 0.01). In addition, a positive correlation was present between lactate extraction and the arterial lactate level (r = 0.78; p < 0.01). In conclusion, myocardial lactate extraction is dependent on multiple metabolic parameters and any absolute value short of production cannot be considered abnormal.