Weiss R G, Kalil-Filho R, Herskowitz A, Chacko V P, Litt M, Stern M D, Gerstenblith G
Peter Belfer Laboratory, Division of Cardiology, Johns Hopkins Hospital, Baltimore, Md 21205.
Circulation. 1993 Jan;87(1):270-82. doi: 10.1161/01.cir.87.1.270.
Although myocardial oxidative tricarboxylic acid (TCA) cycle activity and contractile function are closely linked in normal cardiac muscle, their relation during postischemic reperfusion, when contractility often is reduced, is not well defined.
To test the hypothesis that oxidative TCA cycle flux is reduced in reperfused myocardium with persistent contractile dysfunction, TCA cycle flux was measured by analyzing the time course of sequential myocardial glutamate labeling during 13C-labeled substrate infusion with 13C nuclear magnetic resonance spectroscopy in beating isolated rat hearts at 37 degrees C. Total TCA cycle flux, indexed by both empirical and mathematical modeling analyses of the 13C data, was not reduced but rather increased in hearts reperfused after 17-20 minutes of ischemia (left ventricular pressure, 73 +/- 5% of preischemic values) compared with flux in developed pressure-matched controls (e.g., total flux, 2.5 +/- 0.4 versus 1.6 +/- 0.1 mumol.min-1.g wet wt-1, respectively; p < 0.01). No TCA cycle activity was detectable by 13C nuclear magnetic resonance in hearts reperfused after 40-45 minutes of ischemia, which lacked contractile recovery and had ultrastructural evidence of irreversible injury.
These results suggest that TCA cycle activity is not persistently decreased in dysfunctional reperfused myocardium after a brief ischemic episode and therefore cannot account for the reduced contractile function at that time.
虽然在正常心肌中,心肌氧化三羧酸(TCA)循环活性与收缩功能紧密相关,但在缺血后再灌注期间(此时收缩性常降低),它们之间的关系尚未明确。
为了验证在收缩功能持续异常的再灌注心肌中氧化TCA循环通量降低这一假说,在37℃下,通过用13C核磁共振波谱分析在灌注13C标记底物期间连续心肌谷氨酸标记的时间进程,来测量分离的跳动大鼠心脏中的TCA循环通量。通过对13C数据的经验性和数学模型分析得出的总TCA循环通量,在缺血17 - 20分钟后再灌注的心脏中(左心室压力为缺血前值的73±5%)并未降低,反而增加,与压力匹配的正常对照组相比(例如,总通量分别为2.5±0.4与1.6±0.1 μmol·min-1·g湿重-1;p<0.01)。在缺血40 - 45分钟后再灌注的心脏中,通过13C核磁共振未检测到TCA循环活性,这些心脏缺乏收缩功能恢复且有不可逆损伤的超微结构证据。
这些结果表明,短暂缺血发作后功能异常的再灌注心肌中TCA循环活性不会持续降低,因此不能解释此时收缩功能降低的原因。