Luna-Ortiz P, Rojas-Pérez E, Micheli A, Flores P, Martínez-Rosas M

Language: Spanish
References: 118
Page: 255-274
PDF size: 344.06 Kb.

ABSTRACT

Metabolic therapy is based on the use of drugs which inhibit the fatty acids oxidation and promote glucose oxidation. Ischemic heart disease is cause of angina, acute myocardial infarction and heart failure. The heart is an organ with a very high energy demand which is preferably obtained from the beta-oxidation of fatty acids which provides 60-80% of the ATP production, while the remainder is obtained from the oxidation of carbohydrate (glucose and lactate) and from oxidation of ketone bodies. In condition of myocardial ischemia the metabolism of energy substrates is altered and contractile function is impaired. During ischemia, glycolysis takes a great importance due to their capacity to generate ATP in the absence of oxygen, but has the disadvantage of lactate and proton accumulation, which may reduces the cardiac efficiency. There are drugs that promoting reduction of fatty acid utilization and increasing oxidation of glucose to improve cardiac function due to more efficient use of oxygen in conditions of hypoxia. This review presents the basis for the use of pharmacological agents used in therapy that can modulate energy metabolism of the heart to optimize the use of substrates and decrease the deleterious consequences of ischemia. The experimental and clinical evidence of the benefits of using this therapy is also presented.

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