Triiodothyronine Activates Lactate Oxidation Without Impairing Fatty Acid Oxidation and Improves Weaning From Extracorporeal Membrane Oxygenation
| Autor: | Masaki Kajimoto, Chun Xu, Michael A. Portman, Hidemi Kajimoto, Nancy G. Isern, Dolena R. Ledee |
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| Rok vydání: | 2014 |
| Předmět: |
Pyruvate decarboxylation
Cardiac function curve medicine.medical_specialty Triiodothyronine business.industry medicine.medical_treatment General Medicine Metabolism Surgery Endocrinology Lactate oxidation Internal medicine Extracorporeal membrane oxygenation Medicine Weaning Cardiology and Cardiovascular Medicine business Beta oxidation |
| Zdroj: | Circulation Journal. 78:2867-2875 |
| ISSN: | 1347-4820 1346-9843 |
| DOI: | 10.1253/circj.cj-14-0821 |
| Popis: | Background Extracorporeal membrane oxygenation (ECMO) provides a rescue for children with severe cardiac failure. It has previously been shown that triiodothyronine (T3) improves cardiac function by modulating pyruvate oxidation during weaning. This study focused on fatty acid (FA) metabolism modulated by T3 for weaning from ECMO after cardiac injury. METHODS AND RESULTS: Nineteen immature piglets (9.1-15.3 kg) were separated into 3 groups with ECMO (6.5 h) and wean: normal circulation (Group-C); transient coronary occlusion (10 min) for ischemia-reperfusion (IR) followed by ECMO (Group-IR); and IR with T3 supplementation (Group-IR-T3). 13-Carbon ((13)C)-labeled lactate, medium-chain and long-chain FAs, was infused as oxidative substrates. Substrate fractional contribution (FC) to the citric acid cycle was analyzed by(13)C-nuclear magnetic resonance. ECMO depressed circulating T3 levels to 40% of the baseline at 4 h and were restored in Group-IR-T3. Group-IR decreased cardiac power, which was not fully restorable and 2 pigs were lost because of weaning failure. Group-IR also depressed FC-lactate, while the excellent contractile function and energy efficiency in Group-IR-T3 occurred along with a marked FC-lactate increase and [adenosine triphosphate]/[adenosine diphosphate] without either decreasing FC-FAs or elevating myocardial oxygen consumption over Group-C or -IR. Conclusions T3 releases inhibition of lactate oxidation following IR injury without impairing FA oxidation. These findings indicate that T3 depression during ECMO is maladaptive, and that restoring levels improves metabolic flux and enhances contractile function during weaning. |
| Databáze: | OpenAIRE |
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