Substrate-dependent functional defects and altered mitochondrial respiratory capacity in hearts from guinea pigs with iron deficiency anemia.

Iron deficiency anemia was induced by dietary means in weanling guinea pigs. A 25% higher ventricular wall mass per 100 g body mass was seen after 6 weeks of feeding. Myocardial performance was determined in isolated perfused hearts using an isovolumic Langendorff preparation. All hearts exhibited a 25% decrease in left ventricular developed pressure (LVDP) and decreased dP/dt when substrate was switched from 10 mM pyruvate to 16.6 mM glucose. The glucose reduction in LVDP resulted from decreased systolic pressure, which completely reversed when hearts again metabolized pyruvate. With glucose as substrate, left ventricular developed pressure-end diastolic volume relationships were indistinguishable. However, with pyruvate, iron-deficient hearts appeared to be less responsive to the increased energy demands required by elevated diastolic volumes. Rates of state 3 respiration were 18% below control with glutamate + malate as substrate, and 38% lower with pyruvate + malate in mitochondria isolated from anemic animals. No differences in respiration were noted with succinate. Cytochrome a + a3 content, cytochrome oxidase activity and total mitochondrial protein content appeared to be unchanged. In contrast, cytochromes b, c + c1, and the flavoproteins were significantly decreased. The data suggest that iron deficiency anemia induces cardiac hypertrophy with a fixed but defective mitochondrial population, potentially placing the heart in an energetic imbalance. These differences in mitochondrial function were expressed by decreased myocardial performance when the heart metabolizes pyruvate, an exclusively aerobic substrate.

Metabolic changes preceding functional and morphologic indices of rejection in heterotopic cardiac allografts. A 31P nuclear magnetic resonance study.

Eight beagles receiving heterotopic (cervical) cardiac allografts from outbred donors were evaluated by serial 31P NMR, septal endocardial biopsy, and left ventricular pressure measurements for signs of rejection. Early postoperative myocardial energy levels, as assessed by ratios of phosphocreatine to inorganic phosphate (PCr/Pi) and phosphocreatine to beta-ATP (PCr/B-ATP), were acceptable in all recipients. In these nonimmunosuppressed animals, the mean ratios of PCr/Pi and PCr/B-ATP progressively decreased, with a greater than 25% reduction noted by postoperative day two and greater than 50% reduction by day three. In sharp contrast, left ventricular end-diastolic pressures remained stable and at baseline levels for the first three postoperative days, and only then markedly increased. Likewise, histologic evidence of rejection did not become prominent until postoperative day four. These results suggest that metabolic abnormalities significantly precede either functional or histologic changes in rejecting allografts. The early detection of these metabolic changes by 31P NMR appears to have important potential for the noninvasive diagnosis of cardiac allograft rejection.

Coronary blood flow does not decrease during allograft rejection in heterotopic heart transplants.

To evaluate changes in coronary blood flow during allograft rejection, 16 beagles with cervical cardiac allografts from mongrel donors were immunosuppressed postoperatively for 7 days with cyclosporine (20 mg/kg orally) and prednisone (0.5 mg/kg orally). They were weaned from immunosuppression over 3 days and then treated with methylprednisolone (30 mg/kg/day IV), cyclosporine (20 mg/kg orally), and prednisone (0.5 mg/kg orally) for 4 days. Previous experiments with this model have suggested the utility of phosphorus 31 nuclear magnetic resonance spectroscopy (31P NMR) in the diagnosis of rejection. Therefore in 10 dogs (NMR group) bioenergetic changes during rejection were assessed using the 31P NMR index of the ratio of phosphocreatine to inorganic phosphate (PCr/Pi). To correlate coronary blood flow and graft ischemia with allograft rejection, six dogs (FLOW group) underwent placement of a magnetic flow probe on the left anterior descending coronary artery to determine mean and peak coronary flow. In both NMR and FLOW groups, grafts were evaluated by endomyocardial biopsy (grading 0 to 8 for increasing rejection), and measurement of lactate production and left ventricular end-diastolic pressure. During the initial 7 days of immunotherapy, cellular rejection was effectively suppressed, and the bioenergetic status of the grafts remained stable (day 7: PCr/Pi = 70% of baseline, biopsy score = 2.0). During weaning of immunotherapy, however, the metabolic profile of the grafts decayed (day 10: PCr/Pi = 45% of baseline, biopsy score = 5.8; p less than 0.05 vs day 0). After 4 days of augmented immunosuppression, PCr/Pi recovered to 83% of baseline; this metabolic recovery corresponded with an improvement in mean biopsy score to 3.2.(ABSTRACT TRUNCATED AT 250 WORDS)

Control of heart oxidative phosphorylation by creatine kinase in mitochondrial membranes.

Three important points must be emphasized in summary. First is the idea that a cellular microcompartment need not be limited by a semi-permeable membrane. We recognize microcompartments in multi-enzyme complexes where substrates are covalently transported from subunit to subunit. An example of this is the lipoic acid moiety of the pyruvate dehydrogenase complex. However, to act as a kinetic microcompartment, covalent transfer is not an obligatory requirement. Proximity effects may be sufficient for substantial rate enhancement. Our data clearly show that the kinetics of ADP translocation are influenced by the site of ADP formation. We contend that this represents a newly recognized and important form of cellular microcompartmentation. The second point is that we do not want our results misinterpreted as an overextension of the known data concerning tissue respiration. We believe that the primary parameter controlling heart mitochondrial oxygen consumption is the availability of ADP at the adenine nucleotide translocase. Our data show, however, that this is not a simple process. Secondary control is exerted by the localization of ADP formation, i.e. microcompartmentation. As a result of the kinetic data (Table 3), we conclude that the forward rate of mitochondrial creatine kinase is the preferential reaction controlling ADP delivery to the translocase. We are left, nonetheless, with questions concerning the secondary regulation of this enzyme in vivo by substrate (ATP and creatine) and inhibition by product (phosphocreatine). The nature of this control awaits further experimental data. Finally, the results are consistent with the creatine kinase energy transport hypothesis. Overall, the rate of tissue oxygen consumption reflects the metabolic activity of the organ, determined by the rate of ATP utilization (see right side of Figure 1). This results in the cytoplasmic production of ADP. In heart, this is coupled via the bound cytoplasmic isozymes of creatine kinase to the local rephosphorylation of ADP to ATP and the simultaneous production of creatine.(ABSTRACT TRUNCATED AT 400 WORDS)

31P-NMR study of resting in vitro rat diaphragm exposed to hypercapnia.

We have reported previously that, when exposed to hypercapnia of various intensities, the diaphragm reduces its force of twitch and tetanic contractions in the in vitro rat preparation as well as in the in vivo dog preparation. The experiments reported here with 31P nuclear magnetic resonance (31P-NMR) spectroscopy attempt to examine cellular mechanisms that might be responsible for this deterioration in mechanical performance. Specifically they describe certain characteristics of this preparation and cautions needed to study the resting in vitro rat diaphragm with such techniques. Second, they report the response of intracellular pH (pHi), phosphocreatine (PCr), ATP, and inorganic phosphate (Pi) in the resting in vitro rat diaphragm exposed to long-term normocapnia or to long-term hypercapnia. The results show that 1) to maintain a viable preparation, it was necessary to keep the diaphragm extended to an area approximating that at functional residual capacity, 2) the diaphragm seemed quite capable of maintaining a constant pHi and constant contents of ATP and Pi during normocapnia, but there was a gradual decline in PCr, and 3) during hypercapnia there was a significant decrease in pHi, but the behavior of the phosphate metabolites was exactly as during normocapnia. The results suggest that the decrease in mechanical performance of the diaphragm is probably not due to a decrease in the availability of the high-energy phosphates, although they do not completely exclude this possibility or possibilities related to regional compartmentation.

NMR study of rat diaphragm exposed to metabolic and compensated metabolic acidosis.

When exposed to hypercapnia, several muscles deteriorate with respect to their mechanical performance. Exposure to metabolic acidosis and, perhaps surprisingly, to compensated metabolic acidosis has the same effect on the diaphragm. The mechanisms involved in these effects remain unclear. If the diaphragmatic intracellular pH (pHi) is assumed to decrease with hypercapnia, to remain unchanged during metabolic acidosis, and to increase during compensated metabolic acidosis, it would appear that different mechanisms must be responsible for the depreciation in the diaphragm's mechanical performance. The present experiments using 31P nuclear magnetic resonance (31P-NMR) spectroscopy were undertaken to determine the effect of metabolic acidosis and compensated metabolic acidosis on pHi and on high-energy phosphate metabolites in the resting rat diaphragm. A whole diaphragm was slightly stretched while being stitched onto a fiberglass mesh. The area approximated that at functional residual capacity. It was superfused in the NMR sample tube with a phosphate-free Krebs-Ringer bicarbonate solution [( HCO3-] = 6 meqO equilibrated with either 95% O2-5% CO2 or 98.75% O2-1.25% CO2). Spectra were acquired during 15-min intervals for control (30 min of normal Krebs-Ringer bicarbonate superfusate, equilibrated with 95% O2-5% CO2), for 120 min of exposure to either form of acidosis and for 60 min of recovery with normal superfusate. The pHi decreased rapidly during metabolic acidosis but did not change significantly during compensated metabolic acidosis. In both forms of acidosis, phosphocreatine declined gradually but not significantly, whereas ATP and inorganic phosphate did not change at all. The results suggest that HCO3- passes freely through the diaphragmatic sarcolemma, very much like the cardiac sarcolemma.(ABSTRACT TRUNCATED AT 250 WORDS)

Theoretical support for the heart phosphocreatine energy transport shuttle based on the intracellular diffusion limited mobility of ADP.

Flux rates for phosphate metabolites were calculated using the equation for radial diffusion, assuming heart intracellular conditions and a 5% concentration gradient. The data show that while the flux of phosphocreatine is about 3 times faster than ATP, both are more than two orders of magnitude greater than the known maximum rate of ATP utilization. In contrast, since the concentration of free ADP is very low, its flux is below the maximum rate of ATP turnover, while the flux of creatine is almost 3 orders of magnitude greater than ADP. The data suggest that the rate of high-energy phosphate production could be limited by ADP diffusion, with creatine thus substituting as the primary cytoplasmic-mitochondrial phosphate acceptor.

Respiratory control and the integration of heart high-energy phosphate metabolism by mitochondrial creatine kinase.

This review has attempted to integrate three areas of cellular bioenergetics to present a novel and comprehensive view of heart high-energy phosphate metabolism. The goal has been to provide a rational view for the functions of phosphocreatine, creatine, and creatine kinase in the energy metabolism of muscle. The first point is that mitochondrial respiratory control is influenced by changes in the concentration of ADP, stimulating the adenine nucleotide translocase and oxidative phosphorylation. Secondly, as a consequence of the proximity of mitochondrial creatine kinase to the translocase, there appears to be a kinetic preference for ADP generated by the forward creatine kinase reaction. As a result, in heart, it can be viewed that the end product of oxidative phosphorylation is phosphocreatine. Finally, thermodynamic considerations suggest that phosphocreatine plays a major role to maintain or buffer the ATP content of the myocardium. Under conditions of increased ATP turnover, large-scale increases in the concentration of ADP, along with major decreases in ATP, are minimized by the creatine kinase equilibrium. The system responds to such a demand with substantial changes in phosphocreatine and creatine, which can kinetically increase the rate of mitochondrial creatine kinase and thus oxidative phosphorylation. Theoretical enzymologists have long argued whether enzymes are under kinetic or thermodynamic control. Heart creatine kinase may be a unique example where both types of control simultaneously operate in different microenvironments, with mitochondrial creatine kinase kinetically controlled, while the sarcoplasmic isozyme is influenced by equilibrium thermodynamics. Overall, heart creatine kinase may be a unique example of "kineto-dynamic" metabolic integration.

Substrate-induced alterations of high energy phosphate metabolism and contractile function in the perfused heart.

The bioenergetic basis by which the Krebs cycle substrate pyruvate increased cardiac contractile function over that observed with the Embden-Meyerhof substrate glucose was investigated in the isovolumic guinea pig heart. Alterations in the content of the high energy phosphate metabolites and the rate of high energy phosphate turnover were measured by 31P NMR. These were correlated to the changes in contractile function and rates of myocardial oxygen consumption. Maximum left ventricular developed pressure (LVDP) and high energy phosphates were observed with 16 mM glucose or 10 mM pyruvate. In hearts perfused with 16 mM glucose, the intracellular phosphocreatine (PCr) concentration was 15.2 +/- 0.6 mM with a PCr/Pi ratio of 10.3 +/- 0.9. The O2 consumption was 5.35 mumol/g wet weight/min, and these hearts exhibited a LVDP of 97 +/- 3.7 mm Hg at a constant paced rate of 200 beats/min. In contrast, when hearts were switched to 10 mM pyruvate, the PCr concentration was 18.3 +/- 0.4 mM, the PCr/Pi ratio was 30.4 +/- 2.2, the O2 consumption was 6.67 mumol/g wet weight/min, and the LDVP increased to 125 +/- 3.3 mm Hg. From NMR saturation transfer experiments, the steady-state flux of ATP synthesis from PCr was 4.9 mumol/s/g of cell water during glucose perfusion and 6.67 mumol/s/g of cell water during pyruvate perfusion. The flux of ATP synthesis from ADP was measured to be 0.99 mumol/s/g of cell water with glucose and calculated to be 1.33 mumol/s/g of cell water with pyruvate. These results suggest that pyruvate quite favorably alters myocardial metabolism in concert with the increased contractile performance. Thus, as a mechanism to augment myocardial performance, pyruvate appears to be unique.

Creatine kinase of heart mitochondria. Control of oxidative phosphorylation by the extramitochondrial concentrations of creatine and phosphocreatine.

Defining how extramitochondrial high-energy phosphate acceptors influence the rates of heart oxidative phosphorylation is essential for understanding the control of myocardial respiration. When the production of phosphocreatine is coupled to electron transport via mitochondrial creatine kinase, the net reaction can be expressed by the balanced equation: creatine + Pi----phosphocreatine + H2O. This suggests that rates of oxygen consumption could be regulated by changes in [creatine], [Pi], or [phosphocreatine], alone or in combination. The effects of altering these metabolites upon mitochondrial rates of respiration were examined in vitro. Rat heart mitochondria were incubated in succinate-containing oxygraph medium (pH 7.2, 37 degrees C) supplemented with five combinations of creatine (1.0-20 mM), phosphocreatine (0-25 mM), and Pi (0.25-5.0 mM). In all cases, the mitochondrial creatine kinase reaction was initiated by additions of 0.5 mM ATP. To emphasize the duality of control, the results are presented as three-dimensional stereoscopic projections. Under physiological conditions, with 5.0 mM creatine, increases in Pi or decreases in phosphocreatine had little influence upon mitochondrial respiration. When phosphocreatine was held constant (15 mM), changes in [creatine] modestly stimulated respiratory rates, whereas Pi again showed little effect. With 1.0 mM Pi, respiration clearly became dependent upon changes in [creatine] and [phosphocreatine]. Initially, respiratory rates increased as a function of [creatine]. However, at [phosphocreatine] values below 10 mM, product "deinhibition" was observed, and respiratory rates rapidly increased to 80% State 3. With 2.0 mM Pi or higher, respiration could be regulated from State 4 to 100% State 3. Overall, the data show how increasing [creatine] and decreasing [phosphocreatine] influence the rates of oxidative phosphorylation when mediated by mitochondrial creatine kinase. Thus, these changes may become secondary cytoplasmic signals regulating heart oxygen consumption.

Specific enhancement of the cardiac myofibrillar ATPase by bound creatine kinase.

The kinetic influence of bound creatine kinase (CK) on the Ca(2+)-activated myosin ATPase was evaluated. ATPase rates were measured from 0.8 microM to 3.2 mM MgATP. Under control conditions, the apparent KmATP was 79.9 +/- 13.3 microM. In contrast, the addition of 12.2 mM phosphocreatine (PCr) decreased the apparent KmATP to a value of 13.6 +/- 1.4 microM. To determine if this reduction was merely the result of an ATP maintenance system, ATP was regenerated using either phosphoenolpyruvate and pyruvate kinase (PEP-PK), or PCr and soluble bovine cardiac CK. Data obtained with PEP + PK indicated an apparent KmATP of 65.5 +/- 7.3 microM. To study the effects of exogenous CK, the endogenous CK was irreversibly inhibited with 1 mM iodoacetamide. The kinetics of the ATPase were then examined by adding soluble CK to the incubation medium. Under these conditions, the KmATP was 56.4 +/- 0.86 microM. Therefore, these two ATP regeneration systems could not duplicate the effects of endogenous CK. The reduction of the apparent KmATP by endogenous CK was not the result of an altered inhibition by MgADP. MgADP inhibition was determined to be non-competitive, with a Ki of 5.0 +/- 0.1 mM. These data suggest that the observed kinetic effects reflect the proximity of the enzymes in the myofibrillar bundle, thus emphasizing the importance of bound CK for the localized regeneration of MgATP utilized by the myosin ATPase.

Creatine kinase of heart mitochondria. The progressive loss of enzyme activity during in vivo ischemia and its correlation to depressed myocardial function.

It is now appreciated that mitochondrial creatine kinase (CKm) may play an important role in heart high-energy phosphate metabolism and that this isozyme is solubilized in vitro by dilute solutions of Pi. Since an increase in cellular Pi is known to occur with even brief periods of myocardial ischemia, we investigated the relationship between CKm activity and myocardial performance in rabbit hearts subjected to total global ischemia. CKm activity is expressed as a ratio to mitochondrial malate dehydrogenase (MDHm), a stable marker enzyme. A significant decline in this ratio was observed after only 10 min of ischemia, a time prior to changes in total homogenate creatine kinase activity. After 60 min of ischemia, the CKm/MDHm ratio was depressed by more than 70%. Since there was no restoration of activity following 30 min of reperfusion, we correlated changes in enzyme activity to contractile dysfunction following variable periods of total ischemia. The data showed a close correlation between the decline in the CKm/MDHm ratio and the reduction in performance, measured as left ventricular developed pressure. No correlation was observed between State 3 respiratory rates and performance. Using KCl arrest at 27 degrees C or hyperthermic ischemia at 40 degrees C, the CKm/MDHm ratio consistently correlated to the degree of postischemic functional depression, independent of the duration of ischemia. Isoenzyme electrophoresis failed to detect soluble CKm activity in the postischemic supernatant. Therefore, CKm activity appears to be altered rapidly and irreversibly by ischemia. The implications of these observations on the integration of myocardial high-energy phosphate metabolism are discussed.

Calcium oscillations in digitalis-induced ventricular fibrillation: pathogenetic role and metabolic consequences in isolated ferret hearts.

The pathophysiology of the ventricular fibrillation that complicates digitalis intoxication was investigated. In this and other calcium-overload states, oscillations of the intracellular free calcium concentration ([Ca2+]i) have been implicated as the cause of ventricular tachyarrhythmias. We addressed two questions: 1) Are [Ca2+]i oscillations obligatory in the pathogenesis of ventricular fibrillation during digitalis toxicity? 2) What are the metabolic consequences of [Ca2+]i oscillations? Ferret hearts (n = 20) were Langendorff-perfused at constant flow with oxygenated HEPES-buffered Tyrode's solution at 37 degrees C. Isovolumic left ventricular pressure was measured along with the extracellular electrogram or with simultaneous phosphorus nuclear magnetic resonance spectra. When strophanthidin (20 microM) was added during pacing at 3 Hz, the positive inotropic effect soon gave way to a decrease in developed force. The decrease in force was accompanied by an increase in inorganic phosphate concentration, a decrease in phosphocreatine concentration, and a slight acidosis. The rhythm changed to ventricular fibrillation after 12-25 minutes. This change was initially accompanied by further metabolic deterioration, but all metabolites reached steady state within 12-18 minutes of the onset of ventricular fibrillation. Fast Fourier transformation revealed the existence of periodic oscillations at 7-10 Hz in both the extracellular electrogram and the ventricular pressure during ventricular fibrillation. Ryanodine, an inhibitor of [Ca2+]i oscillations, abolished the pressure oscillations but not the voltage oscillations. Exposure to ryanodine significantly decreased the inorganic phosphate concentration and increased the phosphocreatine concentration (p less than 0.05) despite continuing exposure to strophanthidin. The results indicate that oscillations of [Ca2+]i are not required to sustain ventricular fibrillation, but when present, such oscillations contribute importantly to metabolic deterioration.

Alterations in cardiac sarcoplasmic reticulum calcium transport in the postischemic "stunned" myocardium.

This study examined the possibility that the postischemic mechanical depression observed in the "stunned" myocardium is a result of an alteration in the control of intracellular calcium. Regional myocardial stunning was produced in five open-chest dogs by eight to twelve 5-minute occlusions of the left anterior descending coronary artery, alternated with 10-minute reflow periods and followed by a final 60-minute period of reperfusion. Systolic segment shortening in the postischemic zone, measured by sonomicrometry, fell from 14.9% at baseline to -1.1% at the end of reperfusion. Sarcoplasmic reticulum isolated from stunned myocardium demonstrated a 17% reduction in oxalate-supported 45Ca2+ transport compared with sarcoplasmic reticulum from normal myocardium (0.93 vs. 1.12 mumol Ca2+/mg protein/min, p less than 0.005). There was also a 20% decrease in the maximal activation by Ca2+ of the sarcoplasmic reticulum Ca2+, Mg2+-ATPase (2.46 vs. 1.96 mumol Pi/mg protein/min, p less than 0.005), and a downward shift in the Ca2+-activation curve of the Ca2+, Mg2+-ATPase. These results indicate that myocardial stunning is associated with damage to the calcium-transport system of the sarcoplasmic reticulum. Altered intracellular control may contribute to the inability of the stunned heart to maintain normal mechanical function.

Mitochondrial respiratory control. Evidence against the regulation of respiration by extramitochondrial phosphorylation potentials or by [ATP]/[ADP] ratios.

To explore how mitochondria can respire at high physiological, extramitochondrial phosphorylation potentials, two series of experiments were conducted. In the first, intact rat liver mitochondria were incubated in oxygraph medium containing 5 mM succinate (+rotenone), 1.0 mM ATP, 20 mM glucose, pH 7.2, at 37 degrees C. Yeast hexokinase (0.02 to 1.0 IU) was added to establish steady state rates of respiration. Samples were removed, assayed for ATP, ADP, and Pi content, and ratios were calculated. As previously reported, low rates of respiration were observed at high phosphorylation potential ([ATP]/[ADP] x [Pi]) or [ATP]/[ADP] ratio values, and the rates of respiration increased as these values declined. In a second series of experiments, only sufficient hexokinase was added to potentially stimulate respiration to 90% of the ADP State 3 rate. At constant hexokinase, 0.35 IU, ATP (5 microM to 10.0 mM) was titrated into the medium to establish steady state rates of oxygen consumption. Under these conditions, low rates of respiration correlated with low [ATP]/[ADP] ratios and extramitochondrial phosphorylation potentials, while maximum rates of respiration were observed at high values of these ratios, the opposite of the previous experimental case. Therefore, it may be concluded that these extramitochondrial parameters per se exert little or no regulatory influence on the rates of respiration, and thus matrix ATP synthesis. In both cases, the concentrations of ADP correlated with respiratory rates. Double reciprocal plots were used to estimate the apparent KmADP for respiratory stimulation. The values are 56 microM for constant [ATP] and 15 microM at constant hexokinase. The value calculated from direct ADP pulses was 25 microM. Together, these results suggest that the most plausible explanation of respiratory control is the availability of ADP and the kinetics of its transport by the adenine nucleotide translocase, a hypothesis first proposed by Chance and Williams more than 25 years ago (Chance, B., and Williams, G. R. (1955) J. Biol. Chem. 217, 385-393).

Mechanism of early contractile failure during hypoxia in intact ferret heart: evidence for modulation of maximal Ca2+-activated force by inorganic phosphate.

We tested the hypothesis that accumulation of H+ or inorganic phosphate (Pi) is responsible for the early contractile failure of hypoxia by measuring maximal Ca2+-activated pressure and 31P nuclear magnetic resonance spectra in Langendorff-perfused ferret hearts at 30 degrees C. Maximal Ca2+-activated pressure was identified by the saturation of pressure with respect to [Ca2+]o observed during tetani as [Ca2+]o was increased to 15 mM in HEPES-buffered, 100% O2-bubbled perfusate and during hypoxia induced by bubbling with room air or with 100% N2. Tetani were produced by pacing at 8-12 Hz following exposure to ryanodine (1-5 microM), an inhibitor of Ca2+ release from the sarcoplasmic reticulum, and were elicited once a minute to measure maximal Ca2+-activated pressure during acquisition of nuclear magnetic resonance spectra. An inverse correlation was observed between [Pi] and maximal Ca2+-activated pressure (r = -0.87 mean, n = 12), with an average decline of 8.6% in pressure per 1 mumol/g wet wt. increase in [Pi]. Intracellular pH (pHi) showed no significant correlation with maximal Ca2+-activated pressure (r = 0.49 mean, n = 12). Two other protocols, pacing at variable rates and gated measurements at two different times during the tetanus, were also used to correlate [Pi], pHi, and maximal Ca2+-activated pressure. These protocols confirmed the highly significant correlation between [Pi] and maximal Ca2+-activated pressure, as well as the lack of correlation with pHi. Acidosis induced by NH4Cl (20 mM) or by bubbling with 95% O2/5% CO2 was associated with less than 20% depression of maximal Ca2+-activated pressure in the pHi range down to 6.8, but much greater depression at lower pHi. The data are consistent with depression of maximal Ca2+-activated force during the early phase of hypoxia by Pi but not by H+.

Reduced aerobic metabolic efficiency in globally "stunned" myocardium.

Post-ischemic "stunned" myocardium appears to be metabolically inefficient, since oxygen consumption is preserved, while mechanical work is depressed. The present study investigated whether this metabolic inefficiency represents a basal functional abnormality present in the quiescent myocardium (e.g. abnormal mitochondrial coupling) or is specifically related to muscle contraction. Isolated perfused rabbit hearts (n = 7) were exposed to 20 min zero-flow ischemia to produce post-ischemic myocardial stunning. After 10 min of reperfusion, mean rate-pressure product (mmHg/min), was reduced to 56.1% of baseline in stunned hearts, while mean oxygen consumption (mumol O2/min/g LV) was reduced to only 71.8% of baseline. The ratio of oxygen consumption to rate-pressure product remained significantly elevated throughout 40 min of reperfusion when compared with non-ischemic controls (P less than 0.01). Despite inappropriately high oxygen consumption in the beating stunned heart, basal oxygen consumption measured after KCl arrest was not significantly different from controls (1.07 +/- 0.07 vs. 1.03 +/- 0.04, respectively). These results indicate that the metabolic inefficiency found in stunned myocardium is not a basal abnormality, but rather is related specifically to abnormalities in contraction or electromechanical coupling.

Effects of ATP precursors on ATP and free ADP content and functional recovery of postischemic hearts.

It has been proposed that administration of adenine nucleotide precursors might accelerate replenishment of myocardial ATP and "free" ADP, thus improving recovery of depressed contractility of postischemic hearts. To test this hypothesis, Langendorff-perfused rabbit hearts were subjected to 20 min of global ischemia and reperfused for 2 h with normal perfusate (n = 8) or perfusate containing 100 mumol/l of the ATP precursors adenosine (n = 8) or 5-amino-4-imidazolecarboxamide riboside (AICAriboside; n = 8). After reperfusion, developed pressure in untreated hearts averaged 70-80% of base line, whereas ATP content was reduced to approximately 70% of preischemic values. AICAriboside administration did not increase tissue ATP levels or contractility. However, in every heart that received adenosine during reperfusion, ATP content increased from a mean value of 65 +/- 4% of base line to 84 +/- 5% at the end of reperfusion (P less than 0.001). Free ADP also increased in adenosine-treated hearts from 40 to 50% of base line at the beginning of reperfusion, to normal levels by 60 min. However, no improvement in contractility was observed in the hearts that received adenosine. These results support the hypothesis that decreased availability of nucleotide precursors is responsible for depressed ATP levels in postischemic hearts; however, reduced ATP and free ADP levels may not be directly responsible for the depressed function of stunned myocardium.