Heart Flashcards

1
Q

liver adapts to changing metabolic condition

A
  • portal vein carries nutrients to the liver
  • hepatocytes turn nutrients into fuel
  • hepatocyte enzymes turn over quickly
  • enzymes increase or decrease with changes in diet and the needs of other tissues
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2
Q

fates for glucose-6-phosphate in the liver

A
  • dephosphorylate to yield free glucose to send to other tissues
  • make into liver glycogen
  • enter glycolysis, make acetyl CoA and then ATP for hepatocytes themselves
  • enter glycolysis, make acetyl CoA to be made into fatty acids and then TAGs
  • enter pentose phosphate pathway to yield NADPH and ribose-5-phospahte
  • glycogen -> G1P -> G6P -> glucose -> glycolysis -> acetyl CoA -> energy or fatty acids -> TAG
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3
Q

muscles (myocytes): two types

A
  • slow-twitch (red muscle):
  • fed by many blood vessels
  • rich in mitochondria (to provide energy via slow and steady oxphos)
  • fast twitch (white muscle):
  • fewer mitochondria and lower O2 delivery
  • uses ATP faster and fatigues faster due to greater demands (more tension) combined with reduced O2 delivery
  • endurance training can increase mitochondria
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4
Q

energy source for muscle contraction

A
  • muscle glycogen -> glucose-6-phosphate
  • yields 3 ATP, not 2 (as in glycolysis)
  • glycogen breakdown skips ATP dependent hexokinase rxn
  • pyruvate -> lactate to create NAD+ to enable glycolysis to continue
  • phosphocreatine is another energy source
  • phosphocreatine + ADP -> burst of heavy activity -> creatine + ATP (other way around during rest)
  • acted on by creatine kinase to release ATP
  • during light activity or rest- fatty acids, ketone bodies, blood glucose is used
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5
Q

hormonal control of glycogen mobilization

A
  • epinephrine cascade stimulates glycogen phosphorylase

- break down glycogen in muscle and liver

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6
Q

O2 debt

A
  • after vigorous exercise, rapid breathing continues
  • used for oxidative phosphorylation to build proton gradient and replenish ATP
  • ATP used for gluconeogenesis to use up lactate and restore muscle glycogen concentration (cori cycle)
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7
Q

the cori cycle

A
  • in skeletal muscle that is capable of bursts of activity there is a process that allows the muscle to receive ATP from aerobic mitochondria or anaerobic catabolism that only uses glycolytic path
  • during anaerobic activity lactate is produced
  • lactate enters the blood and goes to the liver -> uses lactate as a fuel
  • uses ATP in gluconeogenesis to make glucose form lactate (during recovery)
  • glucose leaves liver and returns to the muscle which uses its own glycogenic pathway to build up glycogen for next period of active contraction
  • liver making glucose from lactate
  • muscle making lactate from glucose
  • there is a version of the cori cycle that works in the heart
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8
Q

heart muscle versus skeletal muscle

A
  • heart muscle has more mitochondria (50% of cell volume)
  • it is fueled primarily by fatty acids (some ketones, some glucose, some phosphocreatine)
  • uses fatty acids (preferably) as the krebs cycle substrate
  • glycolytic path runs through pyruvate and goes through part of gluconeogenesis to make oxaloacetate and malate -> these are kreb cycle intermediates that can now use the krebs cycle to oxidize acetyl CoA (from fatty acids) all the way to CO2
  • it is an aerobic organ
  • if the O2 supply is cut off, the muscle dies -> myocardial infarction
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9
Q

aerobic organ

A
  • makes ATP in mitochondria
  • substrate of choice will be fatty acid oxidation
  • acetyl CoA is the substrate of the krebs (doesnt prefer)
  • acetyl CoA is used for oxidation not used for biosynthetic purposes
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10
Q

heart: energy

A
  • three major demands: house keeping functions (you need ATP), ion pumping for contraction, contraction (ATP for movement of myosin heads)
  • energy demands are a lot
  • we must integrate fatty acid catabolism and carbohydrate catabolism to get the energy we need
  • getting fatty acids into the mitochondria is the rate limiting step in fatty acid catabolism
  • carnitine acyl transferase shuttles the fatty acids into the heart
  • once the fatty acids are in they will be catabolized/oxidized all the way to acetyl CoA -> no intramitochondrial regulatory step (this is why regulation at the carnitine acyl transferase is important)
  • carbohydrates are converted via the glycolytic pathway to pyruvate
  • pyruvate can be completely oxidized to acetyl CoA via pyruvate dehydrogenase however if there is enough acetyl CoA from fatty acid catabolism it can chose not to
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11
Q

heart: acetyl CoA

A
  • derived from fatty acid catabolism or carbohydrates converted from pyruvate to acetyl CoA via pyruvate dehydrogenase
  • fatty acid oxidation mostly is unregulated
  • fatty acids is the preferred method of making acetyl CoA
  • acyl transferase that make use of carnitine bring fatty acids into the heart -> regulated
  • use a little bit of gluconeogenic pathway to make kreb cycle intermediates in order to make full use of the fatty acid derived acetyl CoA
  • acetyl CoA inhibits pyruvate dehydrogenase -> fatty acid catabolism shuts down carbohydrate metabolism
  • krebs cycle and ETC of mitochondria is supplying the ATP
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12
Q

creatine

A
  • if there is more than enough ATP the heart stores glucose and uses it to make glycogen
  • BUT more importantly it can store creatine
  • creatine can be phosphorylated to phosphocreatine
  • phosphocreatine has a high energy phosphate bond -> high energy nitrogen bond that can be used to make ATP
  • phosphocreatine is hydrolyzed and phosphorylates ADP
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13
Q

advantage of acetyl CoA from fatty acid catabolism/oxidation: 2 inhibition methods

A
  • two products of fatty acid oxidation that we need to consider: coenzyme A in the form of acetyl CoA and NADH
  • both of these products are regulatory towards pyruvate dehydrogenase -> allosteric negative effectors
  • fatty acid oxidation inhibits the oxidation of pyruvate via pyruvate dehydrogenase to acetyl CoA
  • shut down is not extreme bc the activity of the mitochondria is enough to use up a lot of the NADH in ETC and acetyl CoA in the krebs which slows inhibition
  • if krebs and ETC slow down the allosteric negative effectors accumulate and feedback on to pyruvate dehydrogenase
  • NADH and acetyl CoA can shut down pyruvate kinase through another mechanism (analogous to shut down of PFK2 and F26biP
  • a kinase stimulated by cAMP phosphorylates E1 of pyruvate dehydorgenase -> inhibits
  • phosphatase stimulated by insulin removes the phosphate from E1 -> relieves inhibition
  • excess NADH also tends to slow the glycolytic pathway at other steps (glyceraldehyde-3-phosphate dehydrogenase step) -> shys away from glycolysis while fatty acid catabolism is going on
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14
Q

heart: lactate

A
  • heart takes up lactate from skeletal muscle
  • extracts lactate from the blood and use it for fuel
  • relies heavily on lactate generated by anaerobic glycolysis in skeletal muscle and extracted from the blood as a major energy source
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15
Q

depletion of O2 to the heart

A
  • when we decrease blood and therefore O2 we decrease mitchondrial metabolism which is necessary for fatty acid catabolism -> glycolysis increases which causes accumulation of lactate, protons (lower pH)
  • atherosclerotic cardiovascular disease
  • blood passes through at a reduced rate (reduced prefusion) -> low O2 and nutrients
  • reduced reduction of blood and O2 will compromise hearts ability to wash out metabolic products of contractile activity
  • the heart may switch over to some modest anaerobic glycolysis -> uses glycogen stores to supplement reduced glucose form reduced blood flow -> generates lactate
  • accumulation of lactate
  • protons form glycolysis and mitochondrial metabolism will decrease pH -> negative effect on glycolysis (PFK is pH sensitive)
  • if you lower pH the muscle cant carry out glycolytic metabolism as well
  • therefore is glycolysis if slowed, and mitochondrial activity is slowed (low oxygen) -> myocardial infarction
  • clots will cause serious problems
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16
Q

chronic ischemia

A
  • people who blood supply is not completely cut off
  • function normally by reducing the obligate dependency of the heart on fatty acid catabolism
  • partially inhibit the catabolic pathway
  • do this by using trimetazidine- partial inhibitor
  • trimetazidine inhibits thiolase enzyme (beta-ketoaceyl transferase)
  • trimetazidine is a partial inhibitor meaning that fatty acid catabolism is not completely stopped but significantly reduced
  • partially reduction of fatty acid catabolism -> NADH and acetyl CoA (products) is partially depleted -> pyruvate dehydrogenase is less inhibited
  • heart switches from fatty acid catabolism to glycolytic oxidation (pyruvate dehydrogenase) when under chronic ischemia (slow blood flow)
  • glucose and lactate are used as sources of energy (they are not absolutely dependent on O2) -> can use anaerobic when there is less O2
17
Q

diabetes

A
  • ketone bodies accumulate in blood (ketosis)
  • at risk for elevated levels of acetyl CoA and NADH in the cardiac mitochondria
  • endogenously produced acetyl CoA and NADH from fatty acid oxidation combine with the other acetyl CoA NADH cardiac mitochondria -> reduce the ability of the heart to use glycolysis (inhibits pyruvate dehydrogenase)
  • ketone bodies are sources of acetyl CoA
  • only organ that can make ketone bodies, but also cant use -> liver
  • heart can use ketone bodies -> accumulation of acetyl CoA -> poorly perfused (same as chronic ischemia)
18
Q

maintaining angina (chest pain) due to cardiac ischemia

A
  • give insulin -> helps allow entry of glucose into cardiac muscle
  • insulin also relieves the inhibition of pyruvate dehydrogenase E1 through phosphatase
  • improving blood flood -> nitroglycerin (dilates vessels)
  • inhibit fatty acid oxidation with drugs like trimetazidine
19
Q

chloroacetate

A
  • specific inhibitor of the kinase that inhibits E1 by being phosphorylated
  • drug
20
Q

drugs that inhibit the carnitine acyl transferases

A
  • reduces the levels of fatty acids entering the heart

- allow the heart to rely more on glycolysis and carbohydrate metabolism

21
Q

resting state

A

-flux through krebs is low bc there is low local concentrations of NAD+ if the rate of oxidative phosphorylation is low

22
Q

cardiac muscle

A

-benefits from a good O2 supply for mitochondrial function but then uses the glycolytic pathway for synthesis of krebs cycle intermediates rather than acetyl-CoA while fatty acids are preferentially catabolized