Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1971;33(Suppl):129–137. doi: 10.1136/hrt.33.suppl.129

Acute metabolic response in myocardial infarction

L H Opie 1
PMCID: PMC503286  PMID: 4324636

Abstract

Acute myocardial infarction is viewed as a severe trauma causing a generalized metabolic reaction; an acute emotional stress with further metabolic implications; and a localized wound in which there is an acute increase in carbohydrate metabolism, followed by protein synthetic reactions leading to scar formation. The metabolic response is vital to the patient's successful adaptation to his myocardial infarction.

Full text

PDF
129

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allison S. P., Chamberlain M. J., Hinton P. Intravenous glucose tolerance, insulin, glucose, and free fatty acid levels after myocardial infarction. Br Med J. 1969 Dec 27;4(5686):776–778. doi: 10.1136/bmj.4.5686.776. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Anderson B. G. Free thyroxine in serum in relation to thyroid function. JAMA. 1968 Feb 19;203(8):577–582. [PubMed] [Google Scholar]
  3. BAILEY B. N. Hyperglycaemia in burns. Br Med J. 1960 Dec 17;2(5215):1783–1785. doi: 10.1136/bmj.2.5215.1783. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. BERNE R. M. Cardiac nucleotides in hypoxia: possible role in regulation of coronary blood flow. Am J Physiol. 1963 Feb;204:317–322. doi: 10.1152/ajplegacy.1963.204.2.317. [DOI] [PubMed] [Google Scholar]
  5. BIRKE G., DUNER H., LILJEDAHL S. O., PERNOW B., PLANTIN L. O., TROELL L. Histamine, catechol amines and adrenocortical steroids in burns. Acta Chir Scand. 1958 Jan 31;114(2):87–98. [PubMed] [Google Scholar]
  6. Baker L., Barcai A., Kaye R., Haque N. Beta adrenergic blockade and juvenile diabetes: acute studies and long-term therapeutic trial. Evidence for the role of catecholamines in mediating diabetic decompensation following emotional arousal. J Pediatr. 1969 Jul;75(1):19–29. doi: 10.1016/s0022-3476(69)80097-1. [DOI] [PubMed] [Google Scholar]
  7. Braasch W., Gudbjarnason S., Puri P. S., Ravens K. G., Bing R. J. Early changes in energy metabolism in the myocardium following acute coronary artery occlusion in anesthetized dogs. Circ Res. 1968 Sep;23(3):429–438. doi: 10.1161/01.res.23.3.429. [DOI] [PubMed] [Google Scholar]
  8. Burke W. M., Asokan S. K., Moschos C. B., Oldewurtel H. A., Regan T. J. Effects of glucose and nonglucose infusions on myocardial potassium ion transfers and arrhythmias during ischemia. Am J Cardiol. 1969 Nov;24(5):713–722. doi: 10.1016/0002-9149(69)90459-7. [DOI] [PubMed] [Google Scholar]
  9. Ceremuzyński L., Staszewska-Barczak J., Herbaczynska-Cedro K. Cardiac rhythm disturbances and the release of catecholamines after acute coronary occlusion in dogs. Cardiovasc Res. 1969 Apr;3(2):190–197. doi: 10.1093/cvr/3.2.190. [DOI] [PubMed] [Google Scholar]
  10. Cohen R. A., Uhley H. N. Monitoring the blood pH in acute myocardial infarction. The role of acidosis in arrhythmias. JAMA. 1966 Nov 21;198(8):947–949. [PubMed] [Google Scholar]
  11. Ebert P. A., Vanderbeek R. B., Allgood R. J., Sabiston D. C., Jr Effect of chronic cardiac denervation on arrhythmias after coronary artery ligation. Cardiovasc Res. 1970 Apr;4(2):141–147. doi: 10.1093/cvr/4.2.141. [DOI] [PubMed] [Google Scholar]
  12. GAZES P. C., RICHARDSON J. A., WOODS E. F. Plasma catechol amine concentrations in myocardial infarction and angina pectoris. Circulation. 1959 May;19(5):657–661. doi: 10.1161/01.cir.19.5.657. [DOI] [PubMed] [Google Scholar]
  13. GUDBJARNASON S., DESCHRYVER C., CHIBA C., YAMANAKA J., BING R. J. PROTEIN AND NUCLEIC ACID SYNTHESIS DURING THE REPARATIVE PROCESSES FOLLOWING MYOCARDIAL INFARCTION. Circ Res. 1964 Oct;15:320–326. doi: 10.1161/01.res.15.4.320. [DOI] [PubMed] [Google Scholar]
  14. Gerlings E. D., Miller D. T., Gilmore J. P. Oxygen availability: a determinant of myocardial potassium balance. Am J Physiol. 1969 Mar;216(3):559–562. doi: 10.1152/ajplegacy.1969.216.3.559. [DOI] [PubMed] [Google Scholar]
  15. Gerst P. H., Fleming W. H., Malm J. R. A quantitative evaluation of the effects of acidosis and alkalosis upon the ventricular fibrillation threshold. Surgery. 1966 Jun;59(6):1050–1060. [PubMed] [Google Scholar]
  16. Grayson J., Irvine M. Myocardial infarction in the monkey: studies on the collateral circulation after acute coronary occlusion. Cardiovasc Res. 1968 Apr;2(2):170–178. doi: 10.1093/cvr/2.2.170. [DOI] [PubMed] [Google Scholar]
  17. HARRIS A. S., BISTENI A., RUSSELL R. A., BRIGHAM J. C., FIRESTONE J. E. Excitatory factors in ventricular tachycardia resulting from myocardial ischemia; potassium a major excitant. Science. 1954 Feb 12;119(3085):200–203. doi: 10.1126/science.119.3085.200. [DOI] [PubMed] [Google Scholar]
  18. HARRIS A. S., TOTH L. A., TAN E. H. Arrhythmic and antiarrhythmic effects of sodium, potassium, and calcium salts and of glucose injected into coronary arteries of infarcted and normal hearts. Circ Res. 1958 Sep;6(5):570–579. doi: 10.1161/01.res.6.5.570. [DOI] [PubMed] [Google Scholar]
  19. Henderson A. H., Most A. S., Parmley W. W., Gorlin R., Sonnenblick E. H. Depression of myocardial contractility in rats by free fatty acids during hypoxia. Circ Res. 1970 Apr;26(4):439–449. doi: 10.1161/01.res.26.4.439. [DOI] [PubMed] [Google Scholar]
  20. Jacobs H. S., Nabarro J. D. Plasma 11-hydroxycorticosteroid and growth hormone levels in acute medical illnesses. Br Med J. 1969 Jun 7;2(5657):595–598. doi: 10.1136/bmj.2.5657.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Jennings R. B. Early phase of myocardial ischemic injury and infarction. Am J Cardiol. 1969 Dec;24(6):753–765. doi: 10.1016/0002-9149(69)90464-0. [DOI] [PubMed] [Google Scholar]
  22. Jewitt D. E., Reid D., Thomas M., Mercer C. J., Valori C., Shillingford J. P. Free noradrenaline and adrenaline excretion in relation to the development of cardiac arrhythmias and heart-failure in patients with acute myocardial infarction. Lancet. 1969 Mar 29;1(7596):635–641. doi: 10.1016/s0140-6736(69)92009-1. [DOI] [PubMed] [Google Scholar]
  23. Karz A. M. Effects of interrupted coronary flow upon myocardial metabolism and contractility. Prog Cardiovasc Dis. 1968 Mar;10(5):450–465. doi: 10.1016/s0033-0620(68)80003-9. [DOI] [PubMed] [Google Scholar]
  24. Klein R. F., Troyer W. G., Thompson H. K., Bogdonoff M. D., Wallace A. G. Catecholamine excretion in myocardial infarction. Arch Intern Med. 1968 Dec;122(6):476–482. [PubMed] [Google Scholar]
  25. Kurien V. A., Oliver M. F. A metabolic cause for arrhythmias during acute myocardial hypoxia. Lancet. 1970 Apr 18;1(7651):813–815. doi: 10.1016/s0140-6736(70)92412-8. [DOI] [PubMed] [Google Scholar]
  26. Logan R. W., Murdoch W. R. Blood-levels of hydrocortisone, transaminases, and cholesterol after myocardial infarction. Lancet. 1966 Sep 3;2(7462):521–524. doi: 10.1016/s0140-6736(66)92880-7. [DOI] [PubMed] [Google Scholar]
  27. MACKENZIE G. J., FLENLEY D. C., TAYLOR S. H., MCDONALD A. H., STAUNTON H. P., DONALD K. W. CIRCULATORY AND RESPIRATORY STUDIES IN MYOCARDIAL INFARCTION AND CARDIOGENIC SHOCK. Lancet. 1964 Oct 17;2(7364):825–832. doi: 10.1016/s0140-6736(64)90684-1. [DOI] [PubMed] [Google Scholar]
  28. MACLEOD D. P., DANIEL E. E. INFLUENCE OF GLUCOSE ON THE TRANSMEMBRANE ACTION POTENTIAL OF ANOXIC PAPILLARY MUSCLE. J Gen Physiol. 1965 May;48:887–899. doi: 10.1085/jgp.48.5.887. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. McDonald L., Baker C., Bray C., McDonald A., Restieaux N. Plasma-catecholamines after cardiac infarction. Lancet. 1969 Nov 15;2(7629):1021–1023. doi: 10.1016/s0140-6736(69)90637-0. [DOI] [PubMed] [Google Scholar]
  30. Nabarro J. D. The metabolic and endocrine response to acute medical stress. Proc R Soc Med. 1969 Apr;62(4):351–355. doi: 10.1177/003591576906200422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Nelson P. G. Effect of heparin on serum free-fatty-acids, plasma catecholamines, and the incidence of arrhythmias following acute myocardial infarction. Br Med J. 1970 Sep 26;3(5725):735–737. doi: 10.1136/bmj.3.5725.735. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. OPIE L. H., WALFISH P. G. Plasma free fatty acid concentrations in obesity. N Engl J Med. 1963 Apr 4;268:757–760. doi: 10.1056/NEJM196304042681404. [DOI] [PubMed] [Google Scholar]
  33. Oliver M. F., Kurien V. A., Greenwood T. W. Relation between serum-free-fatty acids and arrhythmias and death after acute myocardial infarction. Lancet. 1968 Apr 6;1(7545):710–714. doi: 10.1016/s0140-6736(68)92163-6. [DOI] [PubMed] [Google Scholar]
  34. Olsson R. A. Changes in content of purine nucleoside in canine myocardium during coronary occlusion. Circ Res. 1970 Mar;26(3):301–306. doi: 10.1161/01.res.26.3.301. [DOI] [PubMed] [Google Scholar]
  35. Owen P., Thomas M., Opie L. Relative changes in free-fatty-acid and glucose utilisation by ischaemic myocardium after coronary-artery occlusion. Lancet. 1969 Jun 14;1(7607):1187–1190. doi: 10.1016/s0140-6736(69)92168-0. [DOI] [PubMed] [Google Scholar]
  36. Owen P., Thomas M., Young V., Opie L. Comparison between metabolic changes in local venous and coronary sinus blood after acute experimental coronary arterial occlusion. Am J Cardiol. 1970 May;25(5):562–570. doi: 10.1016/0002-9149(70)90595-3. [DOI] [PubMed] [Google Scholar]
  37. Pinter E. J., Peterfy G., Cleghorn J. M., Pattee C. J. The influence of emotional stress on fat mobilization: the role of endogenous catecholamines and the beta adrenergic receptors. Am J Med Sci. 1967 Nov;254(5):634–651. doi: 10.1097/00000441-196711000-00008. [DOI] [PubMed] [Google Scholar]
  38. Porte D., Jr, Graber A. L., Kuzuya T., Williams R. H. The effect of epinephrine on immunoreactive insulin levels in man. J Clin Invest. 1966 Feb;45(2):228–236. doi: 10.1172/JCI105335. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. RANDLE P. J., GARLAND P. B., HALES C. N., NEWSHOLME E. A. The glucose fatty-acid cycle. Its role in insulin sensitivity and the metabolic disturbances of diabetes mellitus. Lancet. 1963 Apr 13;1(7285):785–789. doi: 10.1016/s0140-6736(63)91500-9. [DOI] [PubMed] [Google Scholar]
  40. REGEN D. M., DAVIS W. W., MORGAN H. E., PARK C. R. THE REGULATION OF HEXOKINASE AND PHOSPHOFRUCTOKINASE ACTIVITY IN HEART MUSCLE. EFFECTS OF ALLOXAN DIABETES, GROWTH HORMONE, CORTISOL, AND ANOXIA. J Biol Chem. 1964 Jan;239:43–49. [PubMed] [Google Scholar]
  41. Raab W. Myocardial electrolyte derangement: crucial feature of pluricausal, so-called coronary, heart disease (dysionic cardiopathy). Ann N Y Acad Sci. 1969 Jul 30;147(17):627–686. doi: 10.1111/j.1749-6632.1969.tb41278.x. [DOI] [PubMed] [Google Scholar]
  42. Rees J. R., Redding V. J. Experimental myocardial infarction by a wedge method: early changes in collateral flow. Cardiovasc Res. 1968 Jan;2(1):43–53. doi: 10.1093/cvr/2.1.43. [DOI] [PubMed] [Google Scholar]
  43. Regan T. J., Harman M. A., Lehan P. H., Burke W. M., Oldewurtel H. A. Ventricular arrhythmias and K+ transfer during myocardial ischemia and intervention with procaine amide, insulin, or glucose solution. J Clin Invest. 1967 Oct;46(10):1657–1668. doi: 10.1172/JCI105657. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Rutenberg H. L., Pamintuan J. C., Soloff L. A. Serum-free-fatty-acids and their relation to complications after acute myocardial infarction. Lancet. 1969 Sep 13;2(7620):559–564. doi: 10.1016/s0140-6736(69)90261-x. [DOI] [PubMed] [Google Scholar]
  45. SAYEN J. J., SHELDON W. F., PEIRCE G., KUO P. T. Polarographic oxygen, the epicardial electrocardiogram and muscle contraction in experimental acute regional ischemia of the left ventricle. Circ Res. 1958 Nov;6(6):779–798. doi: 10.1161/01.res.6.6.779. [DOI] [PubMed] [Google Scholar]
  46. SOWTON E. Cardiac infarction and the glucose-tolerance test. Br Med J. 1962 Jan 13;1(5271):84–86. doi: 10.1136/bmj.1.5271.84. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Schalch D. S. The influence of physical stress and exercise on growth hormone and insulin secretion in man. J Lab Clin Med. 1967 Feb;69(2):256–269. [PubMed] [Google Scholar]
  48. Scheuer J. Myocardial metabolism in cardiac hypoxia. Am J Cardiol. 1967 Mar;19(3):385–392. doi: 10.1016/0002-9149(67)90452-3. [DOI] [PubMed] [Google Scholar]
  49. Sobel B., Jequier E., Sjoerdsma A., Lovenberg W. Effect of catecholamines and adrenergic blocking agents on oxidative phosphorylation in rat heart mitochondria. Circ Res. 1966 Dec;19(6):1050–1061. doi: 10.1161/01.res.19.6.1050. [DOI] [PubMed] [Google Scholar]
  50. Taylor S. H., Saxton C., Majid P. A., Dykes J. R., Ghosh P., Stoker J. B. Insulin secretion following myocardial infarction with particular respect to the pathogenesis of cardiogenic shock. Lancet. 1969 Dec 27;2(7635):1373–1378. doi: 10.1016/s0140-6736(69)90928-3. [DOI] [PubMed] [Google Scholar]
  51. Valori C., Thomas M., Shillingford J. Free noradrenaline and adrenaline excretion in relation to clinical syndromes following myocardial infarction. Am J Cardiol. 1967 Nov;20(5):605–617. doi: 10.1016/0002-9149(67)90001-x. [DOI] [PubMed] [Google Scholar]
  52. Vanderbeek R. B., Ebert P. A. Potassium release in the denervated heart. Am J Physiol. 1970 Mar;218(3):803–806. doi: 10.1152/ajplegacy.1970.218.3.803. [DOI] [PubMed] [Google Scholar]
  53. Weil M. H., Shubin H. Shock following acute myocardial infarction. Current understanding of hemodynamic mechanisms. Prog Cardiovasc Dis. 1968 Jul;11(1):1–17. doi: 10.1016/s0033-0620(68)80007-6. [DOI] [PubMed] [Google Scholar]
  54. Wollenberger A., Krause E. G. Metabolic control characteristics of the acutely ischemic myocardium. Am J Cardiol. 1968 Sep;22(3):349–359. doi: 10.1016/0002-9149(68)90119-7. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES