Impact of aging on substrate metabolism by the human heart.
BACKGROUND
Results of studies in experimental animals have shown that, with age, myocardial fatty acid metabolism decreases, and glucose metabolism increases. Whether similar changes occur in humans is unknown.


METHODS
Seventeen healthy younger normal volunteers (six males, 26 +/- 5 years) and 19 healthy older volunteers (nine males, 67 +/- 5 years) underwent positron emission tomography (PET) under resting conditions in the fasted state. Myocardial blood flow (MBF), myocardial oxygen consumption (MVO(2)), myocardial fatty acid utilization (MFAU) and oxidation (MFAO), and myocardial glucose utilization (MGU) were quantified by PET with (15)O-water, (11)C-acetate, (11)C-palmitate, and(11)C-glucose, respectively.


RESULTS
Although MBF was similar between the groups, MVO(2) was higher in the older subjects (5.6 +/- 1.6 micromol/g/min) compared with younger subjects (4.6 +/- 1.0 micromol/g/min, p < 0.04). Rates of MFAU and MFAO (corrected for MVO(2)) were significantly lower in older subjects than in younger subjects (MFAU/MVO(2): 35 +/- 10 vs. 51 +/- 20 nmol free fatty acids (FFA)/nmol O(2) x 10(-3), p < 0.005, and MFAO/MVO(2): 33 +/- 10 vs. 48 +/- 18 nmol FFA/nmol O(2) x 10(-3), p < 0.004). In contrast, the rates of MGU corrected for MVO(2) did not differ between the groups.


CONCLUSIONS
With aging, humans exhibit a decline in MFAU and MFAO. Although absolute rates of MGU do not increase, by virtue of the decline in MFAU there is likely an increase in relative contribution of MGU to substrate metabolism. The clinical significance of this metabolic switch awaits further study.
Kates
Andrew M
AM
Cardiovascular Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA.
Herrero
Pilar
P
Dence
Carmen
C
Soto
Pablo
P
Srinivasan
Muthayyah
M
Delano
Deborah G
DG
Ehsani
Ali
A
Gropler
Robert J
RJ
D000328:Adult; D000368:Aged; D000375:Aging / Q000097:blood / Q000378:metabolism*; D001786:Blood Glucose; D005227:Fatty Acids / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood*; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging; D009206:Myocardium / Q000378:metabolism*; D010101:Oxygen Consumption; D014055:Tomography, Emission-Computed
D001786:Blood Glucose; D005227:Fatty Acids; D007328:Insulin; D019344:Lactic Acid