Proposed metabolic vicious circle in patients with large myocardial infarcts and high plasma-free-fatty-acid concentrations.
The relation between peak plasma-free-fatty-acid (F.F.A) concentration and size of infarct--as estimated by the plasma-creatine-kinase technique--was investigated in twenty patients with acute myocardial infarction. In eight patients with large infarcts (more than 65 g equivalents) mean infarct size was 136+/-21 g equivalents and mean peak F.F.A. value in the first 12 h was 1-99+/-0-14 mmol/l (mean +/-S.E.M.). In twelve patients with small infarcts, mean infarct size was 36+/-5 g equivalents and mean peak F.F.A. was 1-22+/-0-13 mmol/l (P less than 0-001). Experimental evidence suggests that high circulating F.F.A. concentrations could further extend ischaemic damage. The association between high plasma-F.F.A. and infarct size may give rise to a vicious circle which increases the severity of the ischaemic process in patients with high plasma-F.F.A.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D005230:Fatty Acids, Nonesterified / Q000097:blood* / Q000633:toxicity; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D009206:Myocardium / Q000378:metabolism; D012709:Serum Albumin / Q000032:analysis; D013997:Time Factors
D005230:Fatty Acids, Nonesterified; D012709:Serum Albumin; D005947:Glucose