Metabolic adaptation to a gradual reduction in myocardial blood flow

A. E. Arai, S. E. Grauer, C. G. Anselone, George Pantely, J. D. Bristow

    Research output: Contribution to journalArticle

    45 Citations (Scopus)

    Abstract

    Background: Studies during 20% to 50% reductions in regional coronary blood flow have revealed a number of metabolic and functional adaptations that suggest the heart downregulates energy requirements and contractility in response to ischemia. In contrast to prior studies of sudden changes in coronary blood flow, we tested whether the heart could reduce ATP consumption commensurate with a gradual decrease in coronary brood flow or whether transient metabolic abnormalities are a necessary trigger in this process. Methods and Results: From 0 to 35 minutes, mean left anterior descending coronary artery blood flow was reduced by ≃1% per minute in 10 acutely anesthetized and instrumented swine. Coronary blood flow then was held constant between 35 and 60 minutes at the resulting 35% net blood flow reduction. Although systemic hemodynamics remained stable, a significant decrease in regional left ventricular systolic wall thickening developed (from control value of 45±11% to 18±11% at 60 minutes, P- 1 · 100 g-1). Conclusions: Metabolic markers of ischemia such as ratio of phosphocreatine to ATP, ATP content, lactate content, and lactate production were blunted during this protocol of gradually worsening ischemia. Thus, contractile abnormalities of mild ischemia can develop with minimal metabolic evidence of ischemia. The downregulation of myocardial energy requirements can almost keep pace with the gradual decline in coronary blood flow.

    Original languageEnglish (US)
    Pages (from-to)244-252
    Number of pages9
    JournalCirculation
    Volume92
    Issue number2
    StatePublished - 1995

    Fingerprint

    Ischemia
    Adenosine Triphosphate
    Lactic Acid
    Down-Regulation
    Phosphocreatine
    Regional Blood Flow
    Coronary Vessels
    Swine
    Hemodynamics

    Keywords

    • adenosine triphosphate
    • ischemia
    • lactate
    • metabolism
    • myocardium

    ASJC Scopus subject areas

    • Physiology
    • Cardiology and Cardiovascular Medicine

    Cite this

    Arai, A. E., Grauer, S. E., Anselone, C. G., Pantely, G., & Bristow, J. D. (1995). Metabolic adaptation to a gradual reduction in myocardial blood flow. Circulation, 92(2), 244-252.

    Metabolic adaptation to a gradual reduction in myocardial blood flow. / Arai, A. E.; Grauer, S. E.; Anselone, C. G.; Pantely, George; Bristow, J. D.

    In: Circulation, Vol. 92, No. 2, 1995, p. 244-252.

    Research output: Contribution to journalArticle

    Arai, AE, Grauer, SE, Anselone, CG, Pantely, G & Bristow, JD 1995, 'Metabolic adaptation to a gradual reduction in myocardial blood flow', Circulation, vol. 92, no. 2, pp. 244-252.
    Arai AE, Grauer SE, Anselone CG, Pantely G, Bristow JD. Metabolic adaptation to a gradual reduction in myocardial blood flow. Circulation. 1995;92(2):244-252.
    Arai, A. E. ; Grauer, S. E. ; Anselone, C. G. ; Pantely, George ; Bristow, J. D. / Metabolic adaptation to a gradual reduction in myocardial blood flow. In: Circulation. 1995 ; Vol. 92, No. 2. pp. 244-252.
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