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Myocardial amino acid metabolism in patients with chronic ischemic heart disease

Myokardialer Aminosäuren-Stoffwechsel bei Patienten mit chronisch-ischämischen Herzleiden

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Summary

In nine patients with ischemic heart disease the authors investigated the arterio-coronary venous difference of free amino acids in serum at rest and during pacing. At rest aspartate was the only amino acid with a marked positive arterio-coronary venous difference. At the peak of pacing, in addition to aspartate, there is a significant positive arterio-coronary venous difference in glutamate, leucine and isoleucine and a significantly negative difference in cystine-cysteine and glutamine with asparagine. When expressed in per cent of the arterial level, the negative difference in alanine is also significant. Among the mutual correlations of arterio-coronary venous differences the negative correlation between alanine and lactate is most significant, which suggests that under normal conditions pyruvate is transformed rather to alanine, while in ischemia lactate is formed from pyruvate, and released from the heart muscle. There is also a positive correlation between alanine and glutamine and between leucine, isoleucine and glutamate.

On the other hand, cystine-cysteine correlates very significantly but inversely with leucine, isoleucine and glutamate.

The arterio-coronary venous difference of aspartate, though significantly positive, does not correlate with any other amino acid. The arterio-coronary vernous differences of ammonia and uric acid correlate inversely, whereby uric acid, contrary to ammonia, is practically not released from the heart muscle.

Zusammenfassung

Die Autoren untersuchten bei 9 Patienten mit ischämischen Herzleiden die arterio-koronarvenöse Differenz von freien Fettsäuren im Serum unter Ruhebedingungen und während künstlichem Schrittmacherantrieb. Bei körperlicher Ruhe war Aspartat die einzige Aminosäure mit einer ausgesprochenen positiven arterio-koronarvenösen Differenz. Auf dem Höhepunkt des Schrittmacherantriebs war zusätzlich zum Aspartat eine positive arteriovenöse Differenz für Glutamat, Leucin und Isoleucin und eine signifikant negative Differenz für Cystin-Cystein und Glutamin zusammen mit Asparagin zu verzeichnen. Ausgedrückt als Prozentsatz des arteriellen Spiegels war die negative Differenz auch bei Alanin signifikant. Bei wechselseitiger Korrelation der arteriovenösen Differenzen war die negative Beziehung zwischen Alanin und Lactat am eindeutigsten, was dafür spricht, daß unter normalen Bedingungen Pyruvat eher zu Alanin umgeformt wird, während im Zustand der Ischämie Lactat aus Pyruvat gebildet und vom Herzmuskel freigesetzt wird. Auch ergibt sich eine positive Korrelation zwischen Alanin und Glutamat und zwischen Leucin, Isoleucin und Glutamat. Andererseits korreliert Cystin-Cystein hoch signifikant, aber invers mit Leucin, Isoleucin und Glutamat.

Die arterio-koronarvenöse Differenz von Aspartat, obwohl signifikant positiv, korreliert nicht mit irgendeiner anderen Aminosäure. Die arteriovenösen Differenzen von Ammoniak und Harnsäure korrelieren invers, wobei Harnsäure im Gegensatz zu Ammoniak praktisch nicht aus dem Herzmuskel freigesetzt wird.

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Author notes

  1. V. Brodan

    Present address: Medizinische Klinik, Institut für klinische und experimentelle Medizin, Budějovická 800, 146 22, Praha 4-Krč, Tschechoslowakei

Authors and Affiliations

  1. Cardiovascular Research Centre of the Institute for Clinical and Experimental Medicine, Budějovická 800, Praha 4-Krč, ČSSR

    V. Brodan, J. Fabián, M. Anděl & J. Pechar

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Brodan, V., Fabián, J., Anděl, M. et al. Myocardial amino acid metabolism in patients with chronic ischemic heart disease. Basic Res Cardiol 73, 160–170 (1978). https://doi.org/10.1007/BF01906751

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