Consequences of Fatty Acid Excess in Ischemic Myocardium and Effects of Therapeutic Interventions
Suspicion that long-chain fatty acids may impair cardiac performance was first reported by Hoak and workers (1) who infused stearic acid bound to albumin into previously anticoagulated but otherwise normal dogs and ducks and noticed an increased prevalence of sudden death and heart failure. This same group in later studies reported that elevating serum free fatty acids in geese caused supraventricular tachycardia, ventricular ectopy, and sudden death and was associated histologically with several lesions including myocytic degeneration, destructive changes in myofibrils, and intramitochondrial inclusion particles (2). That this association was something more than just an isolated laboratory finding unique to experimental animals was next reported by Oliver and colleagues (3). In 200 patients suffering acute myocardial infarction, a twofold increase in serum free fatty acids was observed within the first 48 hours following the onset of pain. Patients with the highest increases in serum fatty acids had the highest prevalence of atrial and ventricular arrhythmias; ventricular tachycardia and fibrillation; second and third degree heart blocks; and total numbers of death.
KeywordsFatty Acid Uptake Adenine Nucleotide Translocase Serum Free Fatty Acid Serum Fatty Acid Acyl Carnitine
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