Early changes in myocardial hypoxia: relations among mechanical function, pH, and intracellular redox states.

When rat hearts were subjected to abrupt hypoxia the onset of NADH changes as measured by epicardial fluorescence and of depressed contractility occurred at similar times. Direct measurements of changes in tissue metabolism lagged behind changes in fluorescence and contractility. Calculated NAD:NADH ratios became reduced more rapidly and to a greater extent in the cytoplasm than in the mitochondria, but did not necessarily signal greater changes in total NADH. The detection of depressed contractility before a fall in intracellular pH or a rise in intracellular lactate casts doubt on the postulate that an increase in hydrogen ion is the primary cause of hypoxic myocardial failure.