Why the study?
Lactate is recognized as an efficient myocardial energy substrate with important roles in oxidative metabolism and cardiovascular physiology, leading to the exploration of exogenous lactate administration in acute cardiac disease.
Does exogenous lactate infusion improve cardiac output and perfusion in acute cardiac disease?
Does exogenous lactate infusion improve cardiac output and perfusion in acute cardiac disease?
Exogenous lactate infusion consistently increases cardiac output and improves perfusion across animal models and clinical studies in acute cardiac disease, acting as a potential metabolic and hemodynamic adjunct.
Lactate infusion may support hemodynamics in acute settings; leaves open clinical translation pending human trials.
Lactate, once disregarded as metabolic waste, is now recognized as a metabolite with important roles in oxidative metabolism and cardiovascular physiology. Cardiomyocytes readily oxidize lactate, allowing it to serve as an efficient myocardial energy substrate. On this basis, exogenous lactate administration has been explored in acute cardiac disease. Across animal models and clinical studies, lactate infusion consistently increased cardiac output and improved perfusion. The underlying mechanisms varied with dose and disease state, but involved reduced afterload, enhanced myocardial contractility, and context-dependent chronotropic effects. Mechanistic data support arterial vasorelaxation, venous contraction, and positive inotropy, with links to myocardial energetics and immunometabolic signaling. Overall, available evidence supports lactate as a potential metabolic and hemodynamic adjunct, while highlighting the need for further studies.
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Hørsdal et al. (2026) conducted a review in Acute cardiac disease. Exogenous lactate infusion was evaluated on Cardiac output and perfusion.
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