Lactates, amino acids, other derivatives and provocation tests
Louisot, P.
Archives des Maladies du Coeur et des Vaisseaux 81(Special Issue): 9-22
1988
ISSN/ISBN: 0003-9683 PMID: 3145727 Document Number: 313434
Myocardial metabolism is a dynamic process which, by using lipids, carbohydrates, proteins and heterocyclic compounds, translates the energy liberated by the broken bonds in terms of adenosine triphosphate (ATP). The dynamic character of this metabolism demands extremely precise controlling mechanisms of five main types: availability of substrates, transcriptional and translational effects, post-translational changes, allosteric and non-allosteric effects and shuttle systems. Within this very complex model with its multiple interferences, static analysis of fixed metabolites seems to be quite futile: it can only give a summary and global assessment at blood flow or even cardiac level of a tremendous number of contradictory reactions, and the sophistication of biological analysis does not succeed in hiding our conceptual ignorance. These pessimistic comments are aimed especially at the lactate and other similar tests.