The effects of anaplerotic substrates on D-3-hydroxybutyrate metabolism in the heart.

In this study the effects of propionate, L-valine, L-isoleucine, and DL-methionine on the metabolism of D-3-hydroxybutyrate (D-3-HB) were investigated in the isolated perfused non-working rat heart. Propionate inhibited the utilization (the total removal of D-3-HB by the heart) but stimulated the oxidation of D-3-HB. The degree of D-3-HB inhibition was dependent on the concentrations of propionate and D-3-HB. Furthermore, increasing the concentration of DL-hydroxybutyrate (DL-3-HB) to 16 or 30 mM abolished the inhibitory effect of propionate (4 mM). Whereas increasing the perfusion pressure from 40-80 mmHg stimulated the utilization and the oxidation of D-3-HB; propionate (4 mM) severely inhibited the utilization of D-3-HB at 40 and 80 mmHg, when DL-3-HB was 5 mM. On the other hand insulin (2 mU .ml-1) stimulated the utilization and the oxidation of D-3-HB at perfusion pressure of 40 mmHg, but showed no effect at 80 mmHg. Insulin was unable to overcome the inhibitory effect of propionate. Propionate improved the oxidation but inhibited the utilization of D-3-HB, while L-valine and L-isoleucine showed no effects on the utilization and the oxidation of D-3-HB. DL-methionine increased the utilization of D-3-HB by 14% without noticeable effects on the oxidation of D-3-HB. None of these anaplerotic substrates were suitable to ameliorate the utilization of D-3-HB.