High energy phosphates, anaerobic glycolysis and irreversibility in ischemia.

The effects of severe regional myocardial ischemia in vivo and total ischemia in vitro on energy production by anaerobic glycolysis in dogs are described. The critical feature of ischemic injury in terms of the adenine nucleotide pool is the fact that the demand of severely or totally ischemic tissue for HEP exceeds the capacity of the damaged myocytes to produce it. The consequent depletion of ATP to very low levels and the destruction of the adenine nucleotide pool are associated with, or may be casually related to, the loss of cellular viability.