Current Concepts in Cardiovascular Physiology by Oscar B. Garfein

By Oscar B. Garfein

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The amino acid alanine appears to be, like lactate, an end product of anaerobic glucose breakdown, arising through transamination of glutamate in the following reaction: glutamate + pyruvate —> 2-oxoglutarate + alanine This is, however, not the end of the pathway. While alanine leaves the cell, 2-oxoglutarate is further metabolized and decarboxylated to succinate via sub­ strate-level phosphorylation in the citric acid cycle. Amino acid metabolism dur­ ing myocardial ischemia is discussed in greater detail below.

Because of heart muscle's high energy requirements, it is not sur­ prising that rates of ketone body utilization are higher in this tissue than in other mammalian tissues. 3-Hydroxybutyric Acid Acetoacetate Acetoacetyl-CoA Figure 14. Outline of ketone body metabolism. Ketone bodies (chiefly 3-hydroxybutyric acid and acetoacetate) arise from incomplete oxidation of fatty acids in the liver. When present in high con­ centrations in the liver, ketone bodies enter the bloodstream, where their levels can become very high.

Incorporation of the two additional phosphates does not change the activity of the complex, as shown by Sugden et al. (1978). The presence of additional phosphates, however, retards reactivation of the complex by the phosphatase. Thus, multisite phosphorylations provide an indirect method by which the rate and the extent of the kinase reac­ tions might regulate reactivation of the PDH complex by the phosphatase. , 2 } 2 30 Heinrich Taegtmeyer and Raymond R. , phosphorylated) dehydrogenase, and the total activity of both is approximately 30 U / g of dry weight at 30°C (Randle, 1976).

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