Myocardial ischaemia and metabolic memory

Excerpt

The human heart in the fasting state extracts free fatty acid (FFA), glucose, lactate, pyruvate and ketone bodies from the systemic circulation. A small but consistent net uptake of circulating glucose by the heart is normally demonstrable in the fasting state with reported arterial–venous (AV) differences ranging from 0.15 to 0.23 mmol/l, corresponding to a fractional uptake of only 3% and to an average oxygen extraction ratio of ∼27%. Measurements of the rate of glucose oxidation by radiolabelling techniques in healthy volunteers have shown that, at the most, only about 30% of the glucose uptake is rapidly oxidised and about 15% is converted to lactate [1]. …