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(Circulation Research. 2003;92:1276.)
© 2003 American Heart Association, Inc.

Editorials

Fueling the Heart

Howard E. Morgan

Correspondence to Howard E. Morgan, MD, Evan Pugh Professor of Physiology, Emeritus, Penn State University, 223 Fox Ridge Lane, Winfield, PA 18990. E-mail morgans@ceinetworks.com

Key Words: cardiac metabolism • myocardial work • myocardial ischemia • insulin • anoxia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

An invitation from Eduardo Marbán, on the occasion of the 50th anniversary of Circulation Research, provides an opportunity to reflect on my understanding of the most important advance in regulation of cardiac metabolism. By the early 1950s, the major findings were the observation by Locke and Rosenheim in 1907 that glucose is used as a fuel by the isolated perfused heart and the observation by Bing and coworkers in 1954 that normally beating human hearts prefer fatty acid to any other substrate for oxidation. Bing’s in situ experiments involved measurements of the myocardial extraction of various substrates and oxygen and of coronary flow. Although there is no substitute for studying metabolism of the heart working in a normal environment, these studies do not allow for the exploration of individual enzymatic reactions.

The most important advance in understanding the regulation of cardiac metabolism was the discovery, in the post–World War II era, of the pathways of glycolysis and fatty acid metabolism including the role of membrane transport in glucose uptake. Although heart muscle slices and homogenates were used for studies of glycolysis, some or all of the cardiac muscle cells were disrupted and prevented rigorous studies of membrane permeability.

Regulation of Glucose Transport

I began my research career in 1953 to test the hypothesis that the effect of insulin on glycolysis in muscle is due to acceleration of glucose transport into the cell. After completing medical school at Johns Hopkins and a residency in Obstetrics and Gynecology at Vanderbilt, I joined the laboratory of . . . [Full Text of this Article]