Hacker T A, Renstrom B, Nellis S H, Liedtke A J
Cardiology Section, University of Wisconsin Hospital and Clinics, Madison 53792-3248, USA.
Mol Cell Biochem. 1998 Mar;180(1-2):75-83.
Previously, we reported, alterations in glucose metabolism in a 4 day model of chronic coronary stenosis similar to those described in patients with hibernating hearts. The purpose of this study was 2 fold: (1) to identify whether an acute model of mild, sustained ischemia could effect similar changes, and (2) to determine the effects of pharmacological inhibition of glycolysis. In the first group, extracorporeally perfused, intact pig hearts were subjected to 85 min of a 40% reduction in left anterior descending (LAD) coronary arterial blood flow. A second group was subjected to the same protocol, except after 40 min of LAD regional ischemia, iodoacetate (IAA) was administered to block glycolysis. Ischemia reduced MVO2 by 10% in both groups with a further 20% reduction noted following IAA treatment. Regional systolic shortening was reduced nearly 50% by ischemia and decreased an additional 40% following treatment with IAA. Glycolysis was increased by over 700% with ischemia in the first group. IAA caused a 3 fold reduction in glycolysis as compared to the preceding ischemic period and inhibited lactate production. Fatty acid metabolism was significantly reduced by ischemia in the first group, but was not reduced in the IAA group. Activity of creatine kinase associated with myofibrils was reduced and may have contributed to the contractile dysfunction. In conclusion, this acute model of short-term hibernation demonstrates several metabolic changes previously reported in chronic hibernation and may prove useful in determining mechanisms of substrate utilization in simulated conditions of chronic coronary stenosis and hibernation.
此前,我们报道了在一个为期4天的慢性冠状动脉狭窄模型中,葡萄糖代谢的改变与冬眠心肌患者中所描述的相似。本研究的目的有两个:(1)确定轻度、持续性缺血的急性模型是否能产生类似的变化,(2)确定糖酵解的药理学抑制作用。在第一组中,对体外灌注的完整猪心脏进行左前降支(LAD)冠状动脉血流量减少40%的处理85分钟。第二组接受相同的方案,但在LAD区域缺血40分钟后,给予碘乙酸(IAA)以阻断糖酵解。两组中缺血均使心肌耗氧量(MVO2)降低10%,IAA处理后又进一步降低20%。缺血使区域收缩期缩短减少近50%,IAA处理后又额外减少40%。第一组中缺血使糖酵解增加超过700%。与缺血前期相比,IAA使糖酵解降低了3倍,并抑制了乳酸生成。第一组中缺血使脂肪酸代谢显著降低,但IAA组中未降低。与肌原纤维相关的肌酸激酶活性降低,这可能导致了收缩功能障碍。总之,这种短期冬眠的急性模型显示出了先前在慢性冬眠中报道的几种代谢变化,并且可能在确定慢性冠状动脉狭窄和冬眠模拟条件下底物利用的机制方面证明是有用的。