title: Localized proton NMR observation of [3-13C]lactate in stroke after [1-13C]glucose infusion.
abstract: To assess whether elevated lactate in stable stroke is being actively produced from blood glucose localized 1H NMR stimulated echo spectra were obtained from a patient in the region of a 32-day-old cortical infarct before and 60-100 min after infusion of [1-13C]glucose. Prior to the infusion the spectrum from the region of the infarct contained an elevated resonance from C3 lactate and a greatly reduced resonance from N-acetyl groups relative to an unaffected contralateral region. After the infusion two additional resonances were observed at 62 and -64 Hz relative to the unlabeled resonance of C3 lactate which were assigned on the basis of chemical shift and relative intensity to [3-13C]lactate. The [3-13C]lactate fractional enrichment in the infarct region was measured to be 32% which is within error one-half the average [1-13C]plasma glucose enrichment during the postinfusion NMR measurement. The result suggests that the stroke lactate pool was completely derived from infused glucose.
authors.affiliation: Department of Internal Medicine, Yale School of Medicine.
authors.forename: D L
authors.initials: DL
authors.lastname: Rothman
authors.forename: A M
authors.initials: AM
authors.lastname: Howseman
authors.forename: G D
authors.initials: GD
authors.lastname: Graham
authors.forename: O A
authors.initials: OA
authors.lastname: Petroff
authors.forename: G
authors.initials: G
authors.lastname: Lantos
authors.forename: P B
authors.initials: PB
authors.lastname: Fayad
authors.forename: L M
authors.initials: LM
authors.lastname: Brass
authors.forename: G I
authors.initials: GI
authors.lastname: Shulman
authors.forename: R G
authors.initials: RG
authors.lastname: Shulman
authors.forename: J W
authors.initials: JW
authors.lastname: Prichard
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D002247:Carbon Isotopes; D002561:Cerebrovascular Disorders / Q000097:blood / Q000378:metabolism*; D005240:Feasibility Studies; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D007773:Lactates / Q000096:biosynthesis* / Q000097:blood; D019344:Lactic Acid; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D002247:Carbon Isotopes; D007773:Lactates; D019344:Lactic Acid; D005947:Glucose