Over the past years, the thrust of research in cardiology has been toward an understanding of the engineering of the heart as a pump that transports blood to the various organs of the body. More recently, the fields of biochemistry and biophysics have come to influence heart research. The modern cardiologist can no longer pretend to understand, for example, what is happening to the patient with myocardial infarction or ischemia without understanding the principles of molecular biology. The structure and function of the heart are therefore central themes of cardiological research and practice, which incorporate knowledge and discoveries from diverse disciplines. The importance of lipid metabolism in the myocardium has become clearly understood. In the well-oxygenated heart, fatty acids are the preferred substrates. The fact that the heart derives most of its energy from the oxidation of lipids, which represent the larg est energy store of the body, is logical for an organ that must work throughout our lifetime. There are, however, several lines of evidence that during ischemia, lipids may. be harmful to the heart. High levels of free fatty acids in the serum have been suggested to play a role in causing life-threatening arryhthmias and damage in the ischemic heart. The molecular basis for these effects remains poorly understood, and several possible mechanisms for these harm ful effects have been suggested.
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Table of ContentsLipid Metabolism in the Myocardium.- Overview of Lipid Metabolism.- Factors Influencing the Carnitine-Dependent Oxidation of Fatty Acids in the Heart.- Localization and Function of Lipases and Their Reaction Products in Rat Heart.- Ultrastructural Localization of Lipids in Myocardial Membranes.- Lipid Induced Membrane Abnormalities.- Phospholipase-Induced Abnormalities in the Sarcolemma.- A Surface Charge Hypothesis for the Actions of Palmitylcarnitine on the Kinetics of Excitatory Ionic Currents in Heart.- Modulation of Membrane Function by Lipid Intermediates: A Possible Role in Myocardial Ischemia.- Fatty Acid Effects on Sarcoplasmic Reticulum Function In Vitro.- Ischemia and Lipid-Induced Changes in Myocardial Function.- Factors Influencing the Metabolic and Functional Alterations Induced by Ischemia and Reperfusion.- Factors that Influence Myocardial Levels of Long-Chain Acyl CoA and Acyl Carnitine.- Are Tissue Non-Esterified Fatty Acids (NEFA) Involved in the Impairment of Biochemical and Mechanical Processes during Acute Regional Ischemia in the Heart.- Effects of Myocardial Ischemia and Long Chain Acyl CoA on Mitochondrial Adenine Nucleotide Translocator.- Interventions Used to Modify Lipid-Induced Abnormalities in the Heart.- Fatty Acid and Carnitine-Linked Abnormalities during Ischemia and Cardiomyopathy.- Consequences of Fatty Acid Excess in Ischemic Myocardium and Effects of Therapeutic Interventions.- Membrane Phospholipid Metabolism during Myocardial Ischemia: Mechanisms of Accumulation of Unesterified Arachidonate.- Phospholipase and Ischemic Damage: Possibilities of Interventions.- Importance of Lipid Metabolism in Man.- Cardiac Perfusion, Past and Present.- Clinical Relevance of Free Fatty Acid Excess.- Iodine-123 Phenylpentadecanoic Acid: Detection of Acute Myocardial Infarction in Anesthetized Dogs.- Free Fatty Acid, Catecholamines and Arrhythmias in Man.- Conclusions.- Contributors.