Marshall R C
Department of Medicine, University of California, Los Angeles 90024.
J Clin Invest. 1988 Jul;82(1):86-95. doi: 10.1172/JCI113606.
The relationships between contractile function, myocardial oxygen consumption, and tissue high energy phosphate and lactate content were investigated during partial coronary flow disruption. The experimental preparation was an isolated, isovolumic retrograde blood-perfused rabbit heart. Both developed pressure (r = 0.94) and dp/dt (r = 0.95) exhibited strong linear correlations with myocardial oxygen consumption that were stable for up to 45 min after blood flow reduction. In contrast, tissue high energy phosphate content exhibited nonlinear relationships with both developed pressure and oxygen consumption such that systolic mechanical function and oxidative metabolism declined to 20 and 30% of control values, respectively, before significant abnormalities in myocardial high energy phosphate stores were observed. Similarly, developed pressure and oxygen consumption decreased to 36 and 48% of control, respectively, before abnormal tissue lactate content was detected. The results of this study indicate that: (a) mechanical function is closely related to the rate of oxidative energy production during partial coronary flow disruption, and (b) despite the development of significant contractile dysfunction, tissue high energy phosphate content remains at normal levels except under the most severely flow-deprived conditions. The preservation of tissue energy stores can be explained by the apparent coupling of contractile performance to oxidative energy production, which could function to maintain myocardial energy balance during partial coronary flow restriction.
在部分冠状动脉血流中断期间,研究了收缩功能、心肌耗氧量与组织高能磷酸盐和乳酸含量之间的关系。实验准备为离体的、等容逆行血液灌注兔心。心室内压(r = 0.94)和dp/dt(r = 0.95)与心肌耗氧量均呈现出强烈的线性相关性,在血流减少后长达45分钟内保持稳定。相比之下,组织高能磷酸盐含量与心室内压和耗氧量均呈现非线性关系,以至于在观察到心肌高能磷酸盐储备出现明显异常之前,收缩期机械功能和氧化代谢分别降至对照值的20%和30%。同样,在检测到异常的组织乳酸含量之前,心室内压和耗氧量分别降至对照值的36%和48%。本研究结果表明:(a)在部分冠状动脉血流中断期间,机械功能与氧化能量产生速率密切相关;(b)尽管出现了明显的收缩功能障碍,但除了在最严重的血流受限条件下,组织高能磷酸盐含量仍保持在正常水平。组织能量储备的维持可以通过收缩性能与氧化能量产生之间明显的耦合来解释,这可能在部分冠状动脉血流受限期间起到维持心肌能量平衡的作用。