Biochemistry: index of the functional state of the heart?

The description of metabolic patterns during well defined conditions has been, and will be, a very helpful tool in characterizing reactions of cells, tissues and organs to physiological and pathophysiological situations. As a rule, the measurements yield global values. Discrimination between the integrity of different cellular compartments and individual cell functions is difficult and possible only in particular circumstances. Metabolism is not a static, but a dynamic cellular activity. Status analyses are like stills from a movie. With the present state of the art, however, it seems neither possible nor justified to describe or predict functional performance of the heart using analyses of metabolism, which can be performed simply, rapidly, reliably and with general validity. The best way to assess functional performance is to measure function! Metabolism and metabolites are the fuel and constituent parts of structure and its functions. Because of this, there must be a link between function, structure and metabolic activities and metabolite patterns. The successful symptomatic therapy of myoadenylate deaminase deficiency in patients by administration of ribose [20, 21] is just one good example of the relation between metabolism and function, and of the value of subtle studies of metabolism and analyses of metabolic patterns in animals and in man.