Comprehensive quantification of fuel use by the failing and nonfailing human heart

The heart consumes circulating nutrients to fuel lifelong contraction, but a comprehensive mapping of human cardiac fuel use is lacking. We used metabolomics on blood from artery, coronary sinus, and femoral vein in 110 patients with or without heart failure to quantify the uptake and release of 277 metabolites, including all major nutrients, by the human heart and leg. The heart primarily consumed fatty acids and, unexpectedly, little glucose; secreted glutamine and other nitrogen-rich amino acids, indicating active protein breakdown, at a rate ~10 times that of the leg; and released intermediates of the tricarboxylic acid cycle, balancing anaplerosis from amino acid breakdown. Both heart and leg consumed…

• AD
  American Diabetes Association

  Award: 1-17-PDF-076
• BF
  Blavatnik Family Foundation
• NI
  National Institutes of Health

  Award: 1DP1DK113643
• DR
  Diabetes Research Center

  Award: P30 DK019525
• NH
  National Heart, Lung, and Blood Institute

  Awards: 5T32HL007915, HL142186-01A1, HL126797
• NI
  National Institute of Diabetes and Digestive and Kidney Diseases

  Award: DK114103