Increased carbohydrate utilization may protect the heart during ischemia and reperfusion. Dichloroacetate (DCA) stimulates pyruvate dehydrogenase, which is the rate-limiting step in oxidation of lactate and pyruvate. The purpose of this study was to determine if the myocardial metabolic changes induced by intracoronary DCA during myocardial ischemia were accompanied by improvement in systolic function. A perfusion circuit was created from the carotid to left anterior descending coronary artery (LAD) in 11 anesthetized Yorkshire swine. Data were obtained under strict hemodynamic control at baseline, after 15 min of moderate (30%) LAD flow reduction, and after an additional 15 min of ischemia with either intracoronary DCA (3 mM, n = 6) or saline (n = 5) infusion. DCA decreased lactate release and increased lactate uptake during ischemia as measured by glucose and lactate carbon-labeled tracers. Despite these metabolic changes, no improvement in systolic shortening, microsphere blood flow, or oxygen consumption occurred. Thus, although DCA stimulated carbohydrate metabolism during myocardial ischemia, it did not directly improve systolic function.
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http://dx.doi.org/10.1152/ajpheart.1995.268.2.H879 | DOI Listing |
Eur J Heart Fail
January 2025
School of Cardiovascular and Metabolic Health, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Aims: A cardiovascular magnetic resonance (CMR) approach to non-invasively estimate left ventricular (LV) filling pressure was recently developed and shown to correlate with invasively measured pulmonary capillary wedge pressure (PCWP). We examined the association between CMR-estimated PCWP (CMR-PCWP) and other imaging and biomarker measures of congestion, and the effect of empagliflozin on these, in the SUGAR-DM-HF trial (NCT03485092).
Methods And Results: SUGAR-DM-HF enrolled 105 patients with heart failure with reduced ejection fraction (HFrEF) and pre-diabetes or type 2 diabetes who were randomly assigned to empagliflozin 10 mg or placebo once daily for 36 weeks.
Int J Rheum Dis
January 2025
Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Background: Right ventricular (RV) failure is a well-recognized pivotal prognostic factor of adverse outcomes in pulmonary artery hypertension (PAH), while RV dilation provides significant implications for adaptive or maladaptive changes. PAH is a predominant cause of mortality among patients with connective tissue disease (CTD). This study aims to elucidate the prognostic significance of RV morphology, as assessed by echocardiography (ECHO), in with CTD associated with PAH (CTD-PAH).
View Article and Find Full Text PDFJ Am Heart Assoc
January 2025
Division of Cardiovascular Science, Faculty of Biology, Medicine and Health The University of Manchester Manchester UK.
Background: Heart failure with preserved ejection fraction (HFpEF) is linked to prolonged endoplasmic reticulum (ER) stress. P21-activated kinase 2 (Pak2) facilitates a protective ER stress response. This study explores the mechanism and role of Pak2 in HFpEF pathology.
View Article and Find Full Text PDFJ Family Med Prim Care
December 2024
Department of Orthopedics, B.J Medical College, Ahmedabad, Gujarat, India.
Background: Cardiovascular diseases (CVDs) are one of the most prevalent causes of mortality worldwide, especially significant in low- and middle-income countries. Kyrgyzstan and India represent such nations that face a huge burden of CVD-related deaths globally. Understanding the prevalence of traditional cardiovascular risk factors (CVRFs) in these populations is critical for effective prevention and management strategies.
View Article and Find Full Text PDFJ Family Med Prim Care
December 2024
Department of Pediatrics, PGIMS, Rohtak, Haryana, India.
Involvement of the heart in children with tuberculosis (TB) generally affects the pericardium; however, the myocardium of a child being affected alone and leading to systolic heart dysfunction has rarely ever been reported. We report a case of a 12-year-old child who presented to Pediatric Emergency Services with severe hypotension (BP <5 percentile for the age) and was subsequently diagnosed with severe left ventricular (LV) dysfunction, with an ejection fraction of less than 15%. During the hospital stay, after an exhaustive workup, the child was diagnosed with pulmonary TB with tubercular myocarditis.
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