Cardiac function, substrate utilization, and myocardial energy metabolism studied with 31-P NMR spectroscopy during acute hypoglycemia and hyperketonemia

Johannes Breuer, Kyung J. Chung, Erkkj Pesonen, Richard H. Haas, Brian D. Guth, David Sahn, John R. Hesselink

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Whether severe hypoglycemia alone or in combination with hyperketonemia might cause deterioration of cardiac function has been controversial. Therefore, the influence of acute hypoglycemia (mean 33 mg/dL) with and without hyperketonemia (mean 13 and 3.3 mM) on cardiac function, substrate utilization, and myocardial high energy phosphate levels was studied in 10 mongrel dogs. After 45 min of hypoglycemia, mean aortic pressure, total peripheral resistance, and myocardial oxygen consumption had increased significantly, but other hemodynamic parameters and regional myocardial function had not changed. Additional infusion of 3-hydroxybutyrate did not affect hemodynamic variables significantly. During both metabolic interventions in vivo phosphorus-31 nuclear magnetic resonance spectroscopy showed stable levels of myocardial phosphocreatinine, ATP, as well as the phosphocreatinine/ ATP (3.0-3.2) ratio. Biochemical measurements revealed that hyperketonemia led to significant alterations in arterial concentrations and arteriocoronary venous differences of selected citric acid cycle intermediates, thus confirming previous reports which suggested a blockade of the 2-oxoglutarate-dehydrogenase reaction induced by ketone body oxidation. However, despite this blockade, the energy supply to the heart was not impaired as shown by normal nuclear magnetic resonance spectroscopy and cardiac performance. It is speculated, that the blockade might be due to an enhanced NADH/NAD ratio.

Original languageEnglish (US)
Pages (from-to)536-542
Number of pages7
JournalPediatric Research
Volume26
Issue number6
StatePublished - 1989
Externally publishedYes

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Hypoglycemia
Energy Metabolism
Magnetic Resonance Spectroscopy
NAD
Adenosine Triphosphate
Hemodynamics
Ketoglutarate Dehydrogenase Complex
Ketone Bodies
Citric Acid Cycle
3-Hydroxybutyric Acid
Oxygen Consumption
Vascular Resistance
Phosphorus
Arterial Pressure
Phosphates
Dogs
phosphocreatinine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Breuer, J., Chung, K. J., Pesonen, E., Haas, R. H., Guth, B. D., Sahn, D., & Hesselink, J. R. (1989). Cardiac function, substrate utilization, and myocardial energy metabolism studied with 31-P NMR spectroscopy during acute hypoglycemia and hyperketonemia. Pediatric Research, 26(6), 536-542.

Cardiac function, substrate utilization, and myocardial energy metabolism studied with 31-P NMR spectroscopy during acute hypoglycemia and hyperketonemia. / Breuer, Johannes; Chung, Kyung J.; Pesonen, Erkkj; Haas, Richard H.; Guth, Brian D.; Sahn, David; Hesselink, John R.

In: Pediatric Research, Vol. 26, No. 6, 1989, p. 536-542.

Research output: Contribution to journalArticle

Breuer, J, Chung, KJ, Pesonen, E, Haas, RH, Guth, BD, Sahn, D & Hesselink, JR 1989, 'Cardiac function, substrate utilization, and myocardial energy metabolism studied with 31-P NMR spectroscopy during acute hypoglycemia and hyperketonemia', Pediatric Research, vol. 26, no. 6, pp. 536-542.
Breuer, Johannes ; Chung, Kyung J. ; Pesonen, Erkkj ; Haas, Richard H. ; Guth, Brian D. ; Sahn, David ; Hesselink, John R. / Cardiac function, substrate utilization, and myocardial energy metabolism studied with 31-P NMR spectroscopy during acute hypoglycemia and hyperketonemia. In: Pediatric Research. 1989 ; Vol. 26, No. 6. pp. 536-542.
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