Martin C, Schulz R, Rose J, Heusch G
Abteilung für Pathophysiologie, Zentrum für Innere Medizin des Universitätsklinikums, Essen, Federal Republic of Germany.
Cardiovasc Res. 1998 Aug;39(2):318-26. doi: 10.1016/s0008-6363(98)00086-8.
Short-term myocardial hibernation is characterized by an adaptation of contractile function to the reduced blood flow, the recovery of creatine phosphate content and lactate balance back towards normal, whereas ATP content remains reduced at a constant level. We examined the hypothesis that, despite the absence of ATP recovery, the short-term hibernating myocardium regains an energetic balance.
An enzymatic method was modified for the measurement of inorganic phosphate (Pi) in transmural myocardial drill biopsies (about 5 mg). In 12 anaesthetized swine, moderate ischemia was induced by reduction of coronary inflow into the cannulated left anterior descending coronary artery to decrease regional myocardial function (sonomicrometry) by 50%.
The development of short-term hibernation was verified by the recovery of creatine phosphate content, the persistence of inotropic reserve in response to dobutamine and the absence of necrosis (triphenyl tetrazolium chloride). At 5-min ischemia, Pi was increased from 3.6 +/- 0.3 (SD) to 8.1 +/- 1.1 mumol/gwet wt (p < 0.05). The free energy of ATP hydrolysis (delta GATP) was decreased from -57.8 +/- 0.8 to -52.2 +/- 1.4 kJ/mol (p < 0.05). The relationships between function and Pi (r = -0.81) and delta GATP (r = -0.83), respectively, during control and at 5-min ischemia became invalid at 90-min ischemia, as myocardial blood flow and function remained reduced at a constant level, but Pi decreased back to 4.9 +/- 0.9 mumol/g (p < 0.05 vs. control and 5-min ischemia), and delta GATP fully recovered back to -57.2 +/- 1.3 kJ/mol (p < 0.05 vs. 5-min ischemia).
In short-term hibernating myocardium, myocardial inorganic phosphate content recovers partially and the free energy change of ATP hydrolysis returns to control values. Contractile function remains reduced by mechanisms other than an energetic deficit.
短期心肌冬眠的特征是收缩功能适应血流减少,磷酸肌酸含量和乳酸平衡恢复正常,而三磷酸腺苷(ATP)含量则维持在较低水平。我们检验了一个假设,即尽管ATP未恢复,但短期冬眠心肌仍能恢复能量平衡。
改良了一种酶法,用于测量经壁心肌钻孔活检组织(约5毫克)中的无机磷酸盐(Pi)。在12只麻醉猪中,通过减少插入左前降支冠状动脉的冠状动脉血流量来诱导中度缺血,使局部心肌功能(超声心动图)降低50%。
磷酸肌酸含量的恢复、对多巴酚丁胺的变力性储备的持续存在以及无坏死(氯化三苯基四氮唑)证实了短期冬眠的发展。在缺血5分钟时,Pi从3.6±0.3(标准差)增加到8.1±1.1微摩尔/克湿重(p<0.05)。ATP水解的自由能(ΔGATP)从-57.8±0.8降至-52.2±1.4千焦/摩尔(p<0.05)。在对照期和缺血5分钟时,功能与Pi(r=-0.81)和ΔGATP(r=-0.83)之间的关系在缺血90分钟时失效,因为心肌血流量和功能维持在恒定的降低水平,但Pi降至4.9±0.9微摩尔/克(与对照期和缺血5分钟相比,p<0.05),且ΔGATP完全恢复至-57.2±1.3千焦/摩尔(与缺血5分钟相比,p<0.05)。
在短期冬眠心肌中,心肌无机磷酸盐含量部分恢复,ATP水解的自由能变化恢复到对照值。收缩功能因能量不足以外的机制而持续降低。