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  • Title: [Study on myocardial carbohydrate and energy metabolism during exercise in patients with circulatory diseases (author's transl)].
    Author: Fujiwara K.
    Journal: Jpn Circ J; 1975 May; 39(5):623-46. PubMed ID: 1152195.
    Abstract:
    1. In thirty six patients with various circulatory diseases, the influence of exercise on myocardial carbohydrate metabolism was observed by use of coronary sinus catheterization. Bicycle ergometry was performed in supine position at a level of fifty watts for fifteen minutes. 2. The myocardial carbohydrate metabolism was not significantly affected by the manipulations with coronary sinus catheterization. 3. At resting state, there was no significant difference among disease groups except that myocardial lactate extraction ratio showed lower values in some cases of the patients with coronary heart disease. 4. During exercise, in cases of neurocirculatory asthenia and hypertension without coronary insufficiency, the myocardial carbohydrate usage was increased with the increase in coronary blood flow and the arterial concentration, maintaining of the carbohydrate extraction ratio. In cases of hypertensive coronary failure, the myocardial carbohydrate usage was maintained chiefly with remarkable increase in the arterial concentration in spite of no significant change of coronary blood flow and the carbohydrate extraction ratio. In normotensive coronary heart disease, the myocardial carbohydrate usage decreased or slightly increased, chiefly due to strong decrease in the extraction ratio and to the lowest increase in coronary blood flow. In many cases the carbohydrate release out of the heart muscle was observed. For the most of the cases of the other heart diseases, the latent disturbance of myocardial carbohydrate metabolism was revealed by exercise in spite of the good response of coronary circulation. 5. The myocardial uptake, extraction ratio and usage of lactate were significantly lower in the ischemic ECG positive group than in the negative group, in spite of significantly higher increase in the arterial concentration in the positive group. The myocardial metabolism of pyruvate during exercise was similar to that of lactate, but the myocardial metabolism of glucose was not clearly correlated with ECG changes.
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