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Current Concepts in Cardiovascular Physiology by Oscar B. Garfein

By Oscar B. Garfein

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The PDH complex is attached to the inner side of the inner mitochondrial membrane. The five successive reactions involved in the decarboxylation and ox­ idation of pyruvate are depicted in Table III. In step 1 pyruvate loses its carboxyl group as it reacts to form the hydroxyethyl derivative of the thiazole ring of the thiamine pyrophosphate. Pyruvate decarboxylase also carries out step 2, the transfer of reducing equivalents and the acetyl group from thiamine pyrophos­ phate to the oxidized form of the core enzyme, the dihydrolipoyl transacetylase, forming the 6-acetyl thiolester of the reduced lipoyl groups.

1983). The findings are also of interest in light of the recently reported inhibition of medium- and short-chain fatty acid oxida­ tion in rat heart mitochondria by pyruvate (Man and Brosnan, 1982). The exact mechanism of glucose inhibition of fatty acid metabolism is still unknown. The fifth factor which determines the selection of fuels is hormone levels. Plasma insulin concentrations, and probably the insulin-glucagon ratio, play a major role in the fuel preferences of tissues. Insulin regulates glucose entry into muscle, adipose tissue, and other cells.

It is reasonable to assume that H 0 added to the cycle arises from 2 Figure 19. Metabolic functions of the tricarboxylic acid (TCA) cycle. The TCA cycle assumes a central role in the flow of energy (see Fig. 2). In addition to the combustion of acetyl-CoA, the TCA cycle captures H 0 for the production of reducing equivalents. 2 1. Biochemistry of the Heart 45 the reduction of molecular 0 in the respiratory chain. According to Racker (1981), the production of reducing equivalents from H 0 is probably the most important function of the T C A cycle, in addition to the other functions, including the generation of intermediates such as citrate (the metabolic signal which regu­ lates 6-phosphofructokinase) and the disposition of the products of carbohydrate, fatty acid, and amino acid metabolism.

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