The year of transparency: measuring quality of cardiac care

The assessment of quality of care is becoming increasingly important in healthcare, both globally and in the Netherlands. The Dutch Minister of Health declared 2015 to be the year of transparency, thereby aiming to improve quality of care by transparent reporting of outcome data. With the increasing importance of transparency, knowledge on quality measurement will be essential for a cardiologist in daily clinical care. To that end, this paper provides a comprehensive overview of the Dutch healthcare structure, quality indicators and the current and future assessment of quality of cardiac care in the Netherlands.     

Extra O2 consumption attributable to NADH2 during maximum lactate oxidation in the heart.

The lactate/pyruvate oxidation (Qo₂) ratio was 1.21 ± 0.04 for heart homogenates as compared to 0.92 ± 0.05 for white quadriceps muscle homogenates during state 3 respiration. The extra lactate Qo₂ could be accounted for by the oxidation of additional NADH₂ from lactate, assuming the oxidation of 12 H⁺/lactate and 10 H⁺/pyruvate. A high correlation of 0.92 was observed between extra lactate Qo₂ and activity of heart-type LDH isozyme. This finding and the mitochondrial location of heart-type isozyme (1) suggests the extra lactate Qo₂ in heart homogenates could represent the oxidation of NADH₂ formed from lactate by the mitochondria.     

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