Key enzymes of myocardial energy metabolism in patients with valvular heart disease: relation to left ventricular function.

Endomyocardial biopsies were taken from the apex of the left ventricle in 15 patients operated on for aortic valve disease or ischaemic heart disease and from papillary muscles in six patients operated on for mitral valve disease. Activities of cardiac phosphofructokinase (PFK), total lactate dehydrogenase (LD), its isoenzyme LD1, aspartate aminotransferase (ASAT), total creatine kinase (CK), its isoenzyme MB, citrate synthase (CS) and myoglobin content (MYO) were related to the angiographically determined left ventricular function. Activities of total LD, PFK and PFK/CS ratio were lower in patients with decreased, than in those with normal, left ventricular function. Myoglobin content and activities of CS and ASAT were not related to left ventricular function. It is suggested that depressed left ventricular contractility is associated with a decreased glycolytic capacity while the oxidative capacity is mainly unaltered.