Post ischemic reperfusion and anoxic perfusion in the isolated heart: alteration in distribution of radionuclides and in protein synthesis.

1. Reperfusion after ischemia and perfusion with total anoxia were studied in the isolated guinea pig heart model which permits right ventricular loading and constant coronary perfusion. Deprivation of oxygen in both situations resulted in a marked shift of circulation from the left to the right ventricle with markedly increased spaces of distribution of 99mTc radionuclides and albumin in the latter. 2. In view of the complexities of measuring protein synthesis during ischemia, continuous anoxic perfusion was used to evaluate this parameter in anoxic induced arrest. There was a profound fall in protein synthesis associated with this arrest, accompanied by a fall in ATP, creating phosphate, glycogen, potassium, and a rise in lactate production. The fall in protein synthesis was more marked in the left ventricle, despite the absence of work while it was still beating. 3. The changes in synthesis were almost completely prevented by initiating cardiac arrest with high K+ (16 meq/l) at the same time as anoxia; energy metabolism remained near normal, and recovery of contractility was nearly complete. 4. The studies demonstrated the differences in vascular distribution between the ventricles after ischemia or with perfusion anoxia, the possible difference in availability of substrate to the two ventricles under these conditions, as well as the difference in protein synthetic response, and further support the protective effect of potassium induced arrest on the hypoxic heart.