Abstract
Equilibrium gated radionuclide ventriculography was used to evaluate the effect of intravenous fat-emulsion overload and excess of free fatty acids (FFA) on left ventricular ejection fraction (LVEF) in 20 patients with and without coronary artery disease (CAD). Fifteen of these patients had normal (>50%) baseline LVEF and 5 had low (<50%) baseline LVEF. From 100 to 150 ml of 20% artificial fat emulsion (Liposyn) was infused over 20–25 min. At the end of the infusion, triglyceridemia reached 820±220 mg% and left ventricular ejection fraction decreased from baseline 62±19% (mean±SD) to 58±16% (P<0.05, paired t-test). After completion of Liposyn infusion, 5,000 U of heparin was administered intravenously and monitoring of LVEF was continuod. One and one-half hours following heparin administration, plasma FFA levels reached 3.7+2.0 mmol/l and LVEF rose to 69±19% (P<0.001, paired t-test). Our data indicate that acute intravenous fat overload can suppress and high pathophysiologic levels of FFA can increase LVEF. This effect is more uniform and statistically more reliable in patients with normal LVEF. The study failed to demonstrate any significant difference in the effect of this pharmacologic intervention between patients with and without CAD.
Similar content being viewed by others
References
Abel RM, Fish D, Grossman NL (1983) Hemodynamic effect of intravenous 20% soy oil emulsion following coronary bypass surgery. JPEN 7:534–540
Brown JM, White CJ, Sobol SM, Lull RJ (1983) Increased left ventricular ejection fraction after meal: potential source of error in performance of radionuclide angiography. Am J Cardiol 51:1709–1711
Bucolo G, David H (1973) Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem 19:476–482
Dole VP (1956) A relation between non-esterified fatty acids in plasma and metabolism of glucose. J Clin Invest 35:150–154
Fisch D, Abel RM (1981) Hemodynamic effect of intravenous fat emulsions in patients with heart disease. JPEN 5:402–405
Friedman M, Byers SO, Rosenman RH (1965) Effect of unsaturated fats upon lipemia and conjunctival circulation. JAMA 193:110–114
Fukuzaki H, Okamoto R, Matsuo T (1975) Studies on pathophysiological effect of postalimentary lipemia in patients with ischemic heart disease. Jpn Circ J 39:317–324
Grimes JB, Abel RM (1979) Acute hemodynamic effect of intravenous fat emulsion in dogs. JPEN 3:40–44
Henderson AH, Most AS, Parmley WW, Gorlin R, Sonnenblick EH (1970) Depression of myocardial contractility in rats by free fatty acids during hypoxia. Circ Res 26:439–449
Kjekshus JK, Mjøs OD (1972) Effect of free fatty acids on myocardial function and metabolism in the ischemic dog heart. J Clin Invest 51:1767–1776
Oliver MF, Kurien VA, Greenwood TW (1968) Relation between serum-free-fatty-acids and arrhythmias and death after acute myocardial infarction. Lancet 1 (April):710–714
Regan TJ, Biank K, Gordon S, DeFazio V, Hellems HK (1961a) Myocardial blood flow and oxygen consumption during postprandial lipemia and heparin-induced lipolysis. Circulation 23:55–63
Regan TJ, Timmis G, Gray M, Binak K, Hellems HK (1961b) Myocardial oxygen consumption during exercise in fasting and lipemic subjects. J Clin Invest 40:624–630
Rogers WJ, Stanley AW, Moraski RE, Mantle JA, McDaniel HG, Russell RO, Rackley CE (1975) Effect of heparin-induced free fatty acid elevation on cardiac metabolism, rhythm, and performance in patients with stable coronary artery disease. Clin Res 23:206A (Abstract)
Rogers WJ, McDaniel HG, Moraski RE, Rackley CE, Russell RO (1977) Effect of heparin-induced free fatty acid elevation on myocardial oxygen consumption in man. Am J Cardiol 40:365–372
Simonsen S, Kjekshus JK (1978) The effect of free fatty acids in myocardial oxygen consumption during atrial pacing and catecholamine infusion in man. Circulation 58:484–491
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ackerman, L., Freeman, M.L., Pacold, I. et al. Effect of acute postinfusion lipemia and free fatty acids on myocardial contractility: Assessment with radionuclide ventriculography. Eur J Nucl Med 12, 201–204 (1986). https://doi.org/10.1007/BF00256922
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00256922