Beneficial effect of enhanced myocardial carbohydrate utilisation after oxfenicine (L-hydroxyphenylglycine) in angina pectoris
Although the major myocardial energy supply comes from oxidation of lipid, carbohydrate requires less oxygen for the same energy yield. Oxfenicine has been shown experimentally to favour carbohydrate utilization and its effect in a dose of 3-12 mg/kg was studied in 18 patients with obstructive coronary artery disease, both at rest and during angina induced by rapid atrial pacing. No major haemodynamic changes or side effects were observed after the drug. The mean pacing time to angina was significantly increased from 289 ± 33 s to 360 ± 35 s (P<0.05) and during pacing, myocardial oxygen consumption fell. After the drug there was a significant increase in myocardial extraction of carbohydrate in the form of lactate, pyruvate and glucose during pacing and in contrast, the myocardial extraction of free fatty acids fell significantly. This increase in myocardial carbohydrate extraction associated with a reduced myocardial oxygen consumption, is of potential value not only in the treatment of angina pectoris, but also in the early phases of acute myocardial infarction.