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衰竭缺氧的心脏几乎全依赖于葡萄糖的代谢以维持其能量的需要。虽然这种应急措施只能供给正常心脏所必需的能量的一小部分,但在心力衰竭的情况下,甚至这样仅有的能量供应,也可以满足维持短期的收缩机能。心肌细胞对葡萄糖的可利用性完全依赖于胰岛素的充分供应。在严重的心力衰竭时,由于胰腺血流减少和儿茶酚胺分泌的双重作用,胰岛素的释放受到抑制。在这种情况下,心脏代谢的应急措施由于胰岛素的缺乏而崩溃。虽然早已知道胰岛素和葡萄糖可以抢救衰竭的离体心脏,它尽管有潜在重要的治疗价值,但在心力衰竭时胰岛素的作用及其分泌的管制的问题却被忽视。
Hypoxic heart failure depends almost entirely on the metabolism of glucose to maintain its energy needs. Although such emergency measures can only provide a small fraction of the energy necessary for a normal heart, even in the case of heart failure, even the only energy supply can satisfy the short-term systolic function. The availability of glucose to cardiomyocytes depends entirely on the full supply of insulin. In severe heart failure, insulin release is inhibited due to the dual effects of reduced pancreatic blood flow and catecholamine secretion. In this case, the emergency measures of heart metabolism collapse due to lack of insulin. Although it has long been known that insulin and glucose can rescue failed isolated hearts, despite its potentially important therapeutic value, the issue of the role of insulin and its regulation of secretion in heart failure has been neglected.