Deleterious effect of altered myocardial fatty acid metabolism in kidney disease.

etabolic adaptation likely represents one of the earliest esponses to myocardial ischemia. The myocardium preferntially oxidizes free fatty acids for energy production. owever, the dependency of fatty acid metabolism on xygen makes this process particularly vulnerable to ischeia. Under hypoxemic or ischemic conditions, the energy equirements of the myocardium are met by glucose rather han free fatty acids. Furthermore, recovery of fatty acid etabolism after myocardial ischemia lags behind restoraion of perfusion, resulting in the phenomenon of “metaolic stunning.” This decrease in fatty acid utilization ollowing ischemia can be imaged with fatty acid radiotracrs, particularly -methyl iodophenyl-pentadecanoic acid BMIPP), which demonstrate markedly limited metabolism