Exercise training in swine promotes growth of arteriolar bed and capillary angiogenesis in heart.

Exercise training induces coronary vascular adaptations. The goal of this study was to contrast the effects of training on capillary and arteriolar growth. Minipigs were trained for 1, 3, 8, and 16 wk and compared with controls. Maximal O2 consumption increased continuously throughout the study. Capillary and arteriolar densities and diameters, and proliferation of vascular cells in these vessels, were determined in perfusion-fixed tissue. The arterioles were subdivided into five groups according to diameter: 10-19.9, 20-30, 31-40, 41-70, and 71-120 microgram. The total vascular bed cross-sectional area increased by 37% at 16 wk, mainly because of an increase in the number of the small arterioles and an increase in the diameter of the larger vessels. Capillary density increased at 3 wk and then returned to control levels by 16 wk; concomitantly, the number of arterioles (20-30 microgram) increased at 16 wk. We speculate that the "extra" capillaries observed at 3 wk were the source of the new arterioles.

Increased gene expression of plasminogen activators and inhibitors in left ventricular hypertrophy.

In the early stages of left ventricular hypertrophy (LVH) acute adaptive changes occur in the coronary vasculature as it remodels. Plasminogen activators (PAs) and inhibitors (PAIs) have the potential effects of proteolytic degradation that is relevant to tissue remodeling and angiogenesis. Our study focused on the possible roles of PAI-1, PAI-2, and uPA in tPA in myocyte hypertrophy and angiogenesis in the early and late stages of pressure overload induced left ventricular hypertrophy (LVH). We divided seventeen adult swine, weighing 24.2 +/- 6.5 kg, into four groups: control, sham-operated, early LVH and late heart failure LVH group. At surgery we placed a fixed constrictor on the ascending aorta immediately above the aortic valve. This increased LV systolic pressure from 133 +/- 15 to 193 +/- 24 mm Hg after the surgery. We subdivided the early group into groups of 3 animals each that we euthanized at 8, 24 and 72 h after operation and obtained heart samples for analysis. In the late heart failure group individual animals were euthanized at 55, 59, 62 and 72 days after the detection of congestive heart failure. We also obtained tissue samples from the control and sham-operated swine. Sections for histologic analysis were fixed in 10% buffered formalin. We isolated RNA, size fractionated it using 1% formaldehyde-agarose gel electrophoresis and then did Northern blots. The mRNAs from both PAI-1 and PAI-2 showed a remarkable increase at 8 and 24 h after acute aortic constriction and returned to control by 72 h. Regional differences showed that most of the increases were in the endocardium. Three animals in the late heart failure LVH group were determined to be in congestive heart failure at about 2 months after the onset of aortic constriction. In these animals PAI-1 and PAI-2 were increased in both the left and right ventricles but remained low in an animal of the same elevation in aortic pressure seen by the LV who did not have congestive failure. These data suggest that PA and PAI gene expressions change before morphologic changes occur in the early stages of developing LVH. Also at the time of onset of congestive heart failure this increased expression reappears. PAs and PA inhibitors mRNA levels vary in the different regions of the heart reflecting changing wall stresses. Thus, the PAs and PA inhibitors may play an important role in angiogenesis that occurs during the early stages of LVH. The increased expression in the late stage of LVH may reflect further changes in wall stresses since these animals also showed overt clinical signs of heart failure.

VEGF mRNA is stabilized by ras and tyrosine kinase oncogenes, as well as by UV radiation--evidence for divergent stabilization pathways.

Vascular Endothelial Growth Factor (VEGF) is a pivotal endothelial cell mitogen that mediates both normal and pathological angiogenesis. Although expressed at very low levels in cells not undergoing vascularization, VEGF mRNA is transiently upregulated and stabilized by a variety of extracellular stimuli, and is persistently upregulated and stabilized in many human tumor cell lines (White et al., 1995). Here we demonstrate that oncogenic activation of tyrosine protein kinases and Ras proteins induce a 6- to 16-fold increase in the abundance of VEGF mRNA and a 3- to 5-fold increase in the stability of VEGF mRNA, suggesting that persistent activation of signaling pathways induced by these oncoproteins accounts for overexpression of VEGF in a significant fraction of human tumors. In addition to these oncoproteins, ultraviolet (UV) radiation upregulated and stabilized VEGF mRNA 15- and 5-fold, respectively. While the tyrosine kinase inhibitor, genistein, blocked VEGF upregulation by activated tyrosine protein kinases, and the Ras inhibitor, N-Acetyl-S-trans-farnesyl-L-cysteine (AFC), eliminated VEGF expression in cells transformed by v-Ras, neither agent blocked upregulation by hypoxia or UV radiation. These data argue that multiple divergent pathways upregulate and stabilize VEGF mRNA.

Gene expression in a swine model of right ventricular hypertrophy: intercellular adhesion molecule, vascular endothelial growth factor and plasminogen activators are upregulated during pressure overload.

We have investigated the molecular changes which occur during pressure overload hypertrophy of the RV in swine. Animals were banded on the pulmonary artery so that right ventricular pressure was increased two-fold. The heart was harvested at 3, 7, 24 and 72 h after surgery. Between 7 and 72 h there was evidence of muscle damage and inflammation. Northern blot experiments showed that pressure overload induced a transient increase in the expression of the immediate early genes and in the developmentally regulated atrial natriuretic factor and skeletal muscle alpha actin genes. Consistent with the histological observations of inflammation, increases in the expression of the gene for intercellular adhesion molecule, which encodes a protein involved in the binding of leukocytes by endothelial cells and myocytes, was observed between 3 and 24 h. In addition, the expression of vascular endothelial growth factor, a growth and permeability factor specific for endothelial cells was increased at 3 and 7 h of pressure overload. An increase in the expression of urokinase plasminogen activator and its inhibitors, plasminogen activator inhibitors I and II, was also observed between 3 and 24 h. This was associated with an increase in urokinase activity in the myocardial tissue. These results indicate that hypertrophy in a large mammal such as swine induces a program of gene expression similar to that previously described in rodents and suggests that up-regulation of a variety of other genes is an early response to pressure overload.

Myocardial high-energy phosphate and substrate metabolism in swine with moderate left ventricular hypertrophy.

BACKGROUND: Although left ventricular hypertrophy (LVH) is frequently associated with impaired coronary vasodilator reserve, it is uncertain whether this leads to myocardial ischemia under physiological conditions. The goal of the present study was to determine whether swine with moderate LVH exhibit metabolic evidence of ischemia when myocardial oxygen requirements are increased. METHODS AND RESULTS: Myocardial metabolism was evaluated in an open-chest anesthetized preparation at baseline and during dobutamine infusion in 13 adolescent pigs with moderate LVH induced by supravalvular aortic banding and 12 age-matched control pigs. Transmural myocardial blood flow was quantified with radioactive microspheres; the ratio of phosphocreatine to ATP (PCr/ATP) in the anterior LV free wall was measured by 31P-nuclear magnetic resonance; and anterior wall lactate release was quantified from the arterial-coronary venous difference in 14C- or 13C-labeled lactate. In a subset of 5 animals from each group, the metabolic fate of exogenous glucose was determined from the transmyocardial difference in 6-14C-glucose and its metabolites 14C-lactate and 14CO2. Coronary reserve, as assessed by the ratio of blood flow during adenosine infusion to baseline blood flow, was significantly lower in the LVH pigs compared with controls (3.5 +/- 0.4 versus 5.5 +/- 0.4 mL/g.min, P < .05); however, transmural myocardial blood flow was similar in both groups of pigs, both at baseline and with dobutamine stimulation, probably reflecting the higher coronary perfusion pressure in the LVH pigs. At baseline, PCr/ATP tended to be lower in the LVH pigs (P = .09) but decreased similarly with dobutamine infusion in both groups. Isotopically measured anterior wall lactate release did not differ between the groups at baseline, nor did the increase in lactate release differ during dobutamine stimulation. The uptake of glucose, lactate, and free fatty acids did not differ between the groups in the basal state. However, during dobutamine stimulation, glucose uptake was greater in the LVH group (0.84 +/- 0.09 mumol/g.min versus 0.59 +/- 0.08 mumol/g.min, P < .05). In a subset of animals, 14C-glucose was used to assess glucose oxidation. These data showed that the LVH animals had a greater rate of glucose oxidation (0.6 +/- 0.10 versus 0.28 +/- 0.08 mumol/g.min, P < .05) and a greater rate of glucose conversion to lactate (0.20 +/- 0.04 versus 0.09 +/- 0.02 mumol/g.min, P < .05) compared with the control pigs. CONCLUSIONS: These results suggest that despite their reduced coronary vasodilator reserve and the absence of a greater rise in myocardial blood flow to compensate for a substantially higher LV double product, pigs with this model of moderate LVH do not exhibit a greater susceptibility to myocardial ischemia during dobutamine stress. However, LVH pigs exhibit significantly greater use of exogenous glucose during dobutamine stress, as evidenced by increases in both glucose oxidation and anaerobic glycolysis.

VEGF mRNA is reversibly stabilized by hypoxia and persistently stabilized in VEGF-overexpressing human tumor cell lines.

Solid tumor growth is dependent upon angiogenesis, a process by which soluble factors released from a tumor induce the sprouting and growth of new blood vessels from nearby venules into the tumor. This process of tumor vascularization provides tumor cells with nutrients, oxygen, and an enhanced ability to establish metastasis at peripheral sites by migration through the circulatory system. Vascular endothelial growth factor is a potent angiogenic factor that is expressed at low levels by most normal cells, can be upregulated in normal cells by exposure to hypoxia or phorbol esters, and exhibits high levels of constitutive expression in some human tumors and tumor cell lines. The mechanism underlying the stable change that results in VEGF overexpression in tumors is unknown. Here, we demonstrate that both hypoxia and TPA induce stabilization of VEGF mRNA, that stabilization by hypoxia is rapidly reversible upon reexposure to normoxia, and that tumor cell lines exhibiting constitutive overexpression of VEGF also exhibit constitutive stabilization of VEGF transcripts. Stabilized VEGF transcripts in tumor cells are refractile or nearly refractile toward further stabilization by TPA or hypoxia, respectively. Furthermore, cycloheximide induces stabilization of VEGF mRNA in normal cells but has no effect on VEGF transcript stability in tumor cells that contain stabilized transcripts. These results suggest that normal signal transduction mechanisms mediate stabilization of the VEGF mRNA, and that mutations in this regulatory pathway in tumor cells may lead to chronic message stabilization, overexpression of VEGF proteins, and ensuing tumor vascularization.

Coronary arterial tree remodeling in right ventricular hypertrophy.

We investigated coronary vascular adaptations occurring in right ventricular hypertrophy (RVH). Six pigs had RVH induced by pulmonary artery stenosis for 5 wk. Three pigs served as controls. At autopsy we made silicone elastomer casts of the right coronary arteries (RCA) and collected morphometric data. We organized the segments and their diameters and lengths into a framework of a modified Strahler's ordering scheme in which the order number of an offspring is increased only if its diameter is greater than the diameters of its parents by a specific amount. The segments of the same order arranged in series are combined into elements. In RVH the total number of orders of vessels was larger than the control by 1; the total number of elements in each order increased greatly, whereas the diameters and lengths of each order decreased somewhat. The total RCA resistance decreased in RVH mainly because the total cross-sectional area (CSA) of every order was increased. Because the diameters of the resistance vessels decreased, this decrease in total RCA resistance was due to a numerical increase in resistance vessels. These findings indicate that new flow channels have been established. In contrast, the RCA was remodeled in that the lumen diameter increased. Pressure-flow curves showed a decrease of coronary resistance in RVH, in agreement with the morphometric findings. We conclude that there is significant remodeling of the coronary arterial vasculature in RVH, and any future analysis of coronary hemodynamics of the right ventricle in hypertrophy must take the morphometric remodeling into account.

Heparin accelerates coronary collateral development in a porcine model of coronary artery occlusion.

BACKGROUND: Coronary collaterals develop in response to an ischemic stimulus. However, collateral growth is not sufficient to result in the complete recovery of coronary reserves. Using a porcine model of gradual coronary artery occlusion, we investigated the effect of continuous heparin infusion on coronary collateral development. METHODS AND RESULTS: We placed ameroid constrictors on the left circumflex coronary artery of 16 minipigs; the ameroid constrictors completely occluded the left circumflex coronary artery at 10 +/- 1 days. Half of the animals also were instrumented with subcutaneously placed osmotic pumps and catheters that delivered heparin (300 units/h) into the external jugular vein. At 2, 3, and 4 weeks, we assessed blood flow at rest and during vasodilation using radioactive microspheres. Our results indicate that the animals receiving heparin restored resting myocardial blood flow to normal levels at or before 2 weeks; in contrast, we did not see normal resting myocardial blood flow levels in the untreated-ameroid animals until 3 weeks. Under vasodilated conditions, untreated-ameroid animals experienced a severe loss of coronary reserves at 2 weeks. Although this improved with time, these animals still were significantly underperfused at 4 weeks. In contrast, in the heparin-treated animals, coronary reserves returned to near-normal levels between 3 and 4 weeks. In addition, infarct size was significantly smaller in the heparin-treated animals. CONCLUSIONS: These experiments suggest that the administration of heparin in the early phases of gradual coronary occlusion accelerates the rate of return of normal blood flow under resting conditions, substantially increases the recovery of coronary reserve, and reduces the risk of infarction.

Heart size and maximal cardiac output are limited by the pericardium.

We tested the hypothesis that the pericardium, by restricting heart size, limits maximal cardiac output and oxygen consumption. We studied 15 pigs. Five underwent maximal treadmill running before and 14-21 days after thoracotomy and pericardiectomy; these pigs also received sequential volume infusions to determine end-diastolic pressure-dimension relationships. Five underwent maximal treadmill running before and 14-21 days after thoracotomy (pericardium undisturbed) to determine the effect of thoracotomy on exercise performance. Finally, five underwent thoracotomy, instrumentation, loose closure of the pericardium, and sequential volume infusions to determine the effect of thoracotomy without pericardiectomy on end-diastolic pressure-dimension relationships. Pericardiectomy caused similar increases in maximal cardiac output (29% increase; P = 0.007) and maximal oxygen consumption (31% increase; P = 0.02). These results were associated with increased left ventricular end-diastolic dimension (10% increase; P = 0.01) and an estimated 33% increase in end-diastolic volume. In addition, left ventricular mass was increased by pericardiectomy (18% increase; P < 0.04). Thus the pericardium, by limiting utilization of the Starling mechanism, limits maximal cardiac output, and the limit to cardiorespiratory performance lies not in oxygen utilization, but in oxygen delivery. Furthermore, removal of pericardium is associated with myocardial hypertrophy.

Coronary collateral development in swine after coronary artery occlusion.

We have quantified the development of the coronary collateral circulation in the pig. The collateral circulation was induced to grow by placing an ameroid occluder on the left circumflex coronary artery. Two to 16 weeks after ameroid placement, the coronary collateral circulation was identified after the injection of several colors of a silicone polymer into the coronary arteries and the aorta. We identified intercoronary and extracardiac collaterals and quantified their number, location, size, and wall thickness. Intercoronary collaterals grew to a level that represents a 14-fold increase in normal collateral blood flow under resting conditions compared with the values in an animal not subjected to coronary artery occlusion. Extracardiac collaterals could potentially supply approximately 30% of resting flow. The sources of the extracardiac collaterals were the bronchial and internal mammary arteries. Coronary collateral morphometry and DNA synthesis in the pig heart also were examined. Coronary collaterals had significantly less smooth muscle than did normal arterioles. This may account, in part, for the reduced response of the coronary collaterals to vasodilators. We observed intense DNA synthesis in endothelial and smooth muscle cells in the first 2 or 3 weeks of ischemia. However, DNA synthesis rapidly ceased after this time, coincident with coronary collateral reserve values (ischemic/nonischemic regional blood flow ratios during maximal vasodilation) reaching their maximum level. This suggests that failure of the vessels to continue proliferating accounts for the occurrence of the plateau in blood flow levels.

Coronary vascular remodeling and coronary resistance during chronic ischemia.

Our previous observations that minimal coronary resistance (MCR) decreases by 60% in a model of chronic ischemia suggest that angiogenesis and vascular remodeling occurred. To test this hypothesis we conducted quantitative morphometry on the arteriolar (ART) and capillary (CAP) beds of 14 pigs subjected to chronic ischemia. We induced chronic ischemia by ameroid occlusion of the left circumflex coronary artery for 2 to 8 weeks. We measured numerical densities (ND) and total cross sectional areas (CSA) of the ART and CAP in the ischemic regions. In the same pigs minimal coronary resistance (MCR) was measured during adenosine infusion, using a constant pressure coronary perfusion pump. In 8 other pigs we gave tritiated thymidine to determine the extent of DNA synthesis in smooth muscle and endothelial cells. At autopsy we injected colored silicone into the vessels of these pigs so we could evaluate the coronary collateral vessels as well as the other arterioles. After 3 weeks of ameroid occlusion, ART ND increased 45% above control, while ART CSA increased 21% above control. After 8 weeks of ameroid occlusion, there were further significant increases in ART CSA, but not in their ND. These changes corresponded to a decrease in MCR to 35% of control after 3 weeks of ameroid occlusion. After 8 weeks of ameroid occlusion, MCR had increased to 49% of control, however there was a further increase in ART CSA to 58% above control. DNA synthesis was occurring since endothelial and smooth muscle cells had total DNA labeling indexes of 1.2% (compared to 0.01% for controls) 2-5 days after ameroid occlusion, but were near control levels by 8 weeks. Many arterioles showed endothelial cell denuding and medial damage. Also capillaries showed degenerative changes and new sprouts. Silicone casts of the left circumflex bed vessels showed increased volumes averaging 55% more than controls. These data imply that angiogenesis is partly responsible for the decreased minimal coronary resistance seen in chronic ischemia. The loss of wall integrity in old arterioles and increased compliance in newly formed arterioles and capillaries also may contribute to the reduced resistance. Newly formed vessels are a significant portion of the total number of vessels. The combined effect of these changes is a reduced minimal coronary resistance that is modulated by 8 weeks. Measurements of coronary collateral growth paralleled the changes in the ischemic bed suggesting that angiogenesis factors controlling growth in both the bed at risk and its periphery are controlled by similar temporal events.

Compensatory angiogenesis during progressive right ventricular hypertrophy.

We investigated vascular adaptations occurring in progressive right ventricular hypertrophy (RVH) in adult mini pigs. Fourteen mini pigs had progressive RVH induced by implanting an inflatable cuff on the main pulmonary artery for 1-5 months and were compared to a control group (N = 11). RVH animals were divided into two groups, a moderate RVH (MH) that had RV/BW ratio increases of 20%-70% above controls and a severe hypertrophy group (SH) that had RV/BW ratio increase of 70%-117%. We measured coronary blood flow reserve (CBFR) with radiolabelled microspheres at maximal exercise and during adenosine vasodilation. Adenosine vasodilation did not decrease CBFR either regionally or transmurally in both the MH and SH groups. During exercise CBFR showed a small but significant decrease in the SH group. No intervention changed the endo/epi flow ratios. Morphometric studies showed that myocytes increased in cross sectional areas (CSA) in these hypertrophied hearts. The CSA of capillaries and arterioles and their numerical densities increased significantly in the endocardial and epicardial regions in both MH and SH groups. Capillary density showed a small but significant decrease in both MH and SH groups. We measured DNA synthesis in these hearts using tritiated thymidine labelling. We found a high labelling index in endothelial cells and a moderate labelling index in smooth muscle cells in early stages of hypertrophy. These data show that angiogenesis, observed in the morphometric studies and by DNA labelling, prevents CBFR changes during progressive RVH in the pig. Furthermore, angiogenesis is not uniform at different stages of progressive RVH.

Myocardial beta-adrenergic receptor expression and signal transduction after chronic volume-overload hypertrophy and circulatory congestion.

BACKGROUND: The volume-overload, high-output state induced by aortocaval fistula is unique because it is not generally associated with marked abnormalities of contractile function. Thus, changes in beta-adrenergic receptor (beta AR) expression should reflect more directly the influence of neurohumoral adrenergic tone, clarifying the manner in which peripheral (neurohumoral) versus primary myocardial factors are operative in decreased beta AR-dependent signal transduction. METHODS AND RESULTS: We examined the beta-adrenergic receptor-responsive adenylyl cyclase pathway in hearts from pigs subjected to volume-overload hypertrophy with circulatory congestion. Nine pigs underwent initial pharmacological and hemodynamic studies, and, 5 weeks after aortocaval fistula placement, when signs of circulatory congestion were evident, these measurements were repeated. Biochemical analyses of plasma and myocardium from these animals and seven normal animals were compared. Experimental animals showed signs of circulatory congestion (tachypnea, weight gain, pulmonary rales) within 3-4 weeks of fistula placement. Necropsy showed ascites and biventricular cardiac hypertrophy, but no fibrosis or inflammation was present on histological inspection. Heart rate responsiveness to beta AR stimulation was blunted, with ED50, for isoproterenol increased 133% (p less than 0.001) after development of circulatory congestion. Biochemical analyses of the beta AR-responsive adenylyl cyclase pathway showed uniform decreases in beta AR number in right atrium, right ventricle, and left ventricle (36-41% decreases, p less than 0.005). Downregulation was selective for beta 1-receptors, and remaining receptors in the right and left ventricles showed low-affinity agonist binding, suggesting an uncoupling from Gs. All measures of adenylyl cyclase activity were diminished significantly in membrane homogenates from the right atrium (mean reduction, 50 +/- 10%) and left ventricle (mean reduction, 44 +/- 8%) after volume overload. Finally, we found that amounts of cardiac Gs, as measured in reconstitution assays, were decreased in both the right atrium (p less than 0.02) and the left ventricle (p less than 0.01) of volume-overloaded animals but that levels of pertussis toxin substrate were unchanged. CONCLUSIONS: Biochemical findings occurred in the absence of myocardial inflammation or fibrosis and without pharmacological interventions, suggesting that circulatory congestion, with attendant elevation in plasma norepinephrine, may be a sufficient stimulus to induce such changes. The data are compatible with a catecholamine-driven beta AR pathway desensitization. Thus, a primary defect in intrinsic contractile function is not a necessary component for abnormalities of the myocardial beta AR-responsive adenylyl cyclase pathway.

Effects of feeding on muscle blood flow during prolonged exercise in miniature swine.

Eight exercise-trained miniature swine were studied during prolonged treadmill runs (100 min) under fasting and preexercise feeding conditions. Each animal ran at identical external work loads that corresponded to 65% of the heart rate reserve (210-220 beats/min) for the two exercise bouts. Cardiac outputs and stroke volumes were higher and heart rates lower for fed than for fasting runs (P less than 0.05). Preexercise feeding did not alter oxygen consumption, core temperature, mean arterial pressure, and arterial-mixed venous oxygen difference during prolonged exercise; however, mixed venous lactate concentration was lower at end exercise than during fasting conditions (1.2 vs. 2.6 mM, P less than 0.05). Microsphere measurements of regional blood flow revealed significantly higher total gastrointestinal flow (23%) for fed than for fasting conditions. Throughout the exercise bout, blood flow to the biceps femoris, semitendinosus, and tibialis anterior muscles was lower in fed than in fasted animals (P less than 0.05). Combined hindlimb muscle blood flow averaged 15 ml.min-1.100 g-1 (18%, P less than 0.05) lower under feeding than fasting run conditions. These findings provide further evidence that cardiovascular reflexes originate in the gut after feeding to increase cardiac output and redistribute a portion of the blood flow away from active muscle to the gastrointestinal tract during prolonged exercise.

Effect of long-term exercise on regional myocardial function and coronary collateral development after gradual coronary artery occlusion in pigs.

The effect of myocardial ischemia, induced by long-term exercise, on regional myocardial function and coronary collateral development was examined in pigs after gradual occlusion of the left circumflex coronary artery (LCx) with an ameroid occluder. Thirty days after surgery, regional myocardial function and blood flow were assessed during exercise in 22 pigs separated into exercise (n = 12) and sedentary groups (n = 10). The exercise group trained on a treadmill for 25 +/- 1 days, 30-50 min/day, at heart rates of 210-220 beats/min. After 5 weeks, another exercise test was performed. In the exercise group, after training, we observed an improvement in systolic wall thickening, expressed as a percentage of rest, in the collateral-dependent LCx region from 64 +/- 8% to 87 +/- 6% (p less than 0.01) at moderate exercise levels (220 beats/min) and from 45 +/- 7% to 73 +/- 7% (p less than 0.01) at severe exercise levels (265 beats/min). Transmural myocardial blood flow in the LCx region expressed as a ratio of flow in the nonoccluded region of the left ventricle also increased significantly (p less than 0.01) during severe exercise after 5 weeks. The sedentary group showed an improvement in systolic wall thickening in the LCx region during moderate exercise compared with the initial exercise test (p less than 0.05) but no significant change in systolic wall thickening or myocardial blood flow ratios during severe exercise after 5 weeks. We conclude that long-term exercise after gradual LCx coronary artery occlusion in pigs improves myocardial function and coronary collateral reserve in collateral-dependent myocardium during exercise.

Responses of harbor seal and pig heart to progressive and acute hypoxia.

Myocardial oxidative and glycolytic reserves were evaluated in four harbor seals, Phoca vitulina richardsi, and six domestic pigs, Sus scrofa (hematocrits: 58 +/- 5 and 34 +/- 1%., respectively). Progressive hypoxia was induced by lowering arterial hemoglobin-oxygen saturation in 10% decrements, each maintained for 10-min periods, until the onset of heart failure. Myocardial oxygen consumption rate (VO2), lactate release/uptake rate (L), and triple product, an index of myocardial energetic demand, were determined at each saturation level. Onset of L began in pigs at Sao2 = 57 +/- 5% and in seals at Sao2 = 35 +/- 4%. Cumulative oxygen consumption (VO2) during hypoxia, determined from the onset of cardiac lactate release, was 435 ml O2/100 g in seals and 172 ml O2/100 g in pigs. Cumulative lactate release during the same period was 14 mM/100 g in seals and 4.6 mM/100 g in pigs. The pigs' left ventricular contractile response (dP/dtmax) was greater than that of seals throughout the time of lactate release. Total myocardial energetic sources were higher in seals than in pigs, and seals were better able to tolerate myocardial hypoxia than were pigs. In a separate experiment, two seals and six pigs were made acutely hypoxic until cessation of cardiac output (seals, 17.5 min; pigs, 7.4 min) and were then reoxygenated. Both seals recovered promptly to control levels of cardiac mechanical function, whereas none of the pigs recovered. Additionally, five pigs were beta-blocked with 0.10 mg/kg of propranolol and were subjected to acute hypoxia. Tolerance to cardiac hypoxia in beta-blocked pigs was significantly increased compared with that of control animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Myocardial lactate release during ischemia in swine. Relation to regional blood flow.

To determine the relation between regional myocardial blood flow, contractile function, and myocardial lactate release during mild-to-moderate regional myocardial ischemia, nine open-chest swine were instrumented for measurement of regional myocardial blood flow (microsphere method), contractile function (sonomicrometry), and hemodynamics. L-[1-14C]Lactate or L-[U-13C]lactate was infused intravenously using a primed continuous infusion technique to quantify regional myocardial lactate release. D-[U-13C]glucose or D-[6-14C]glucose was simultaneously infused to determine the contribution of exogenous glucose to lactate release. Graded coronary ischemia (two to three levels) was created in the left anterior descending coronary arterial distribution by mechanically constricting the artery in five animals or by decreasing flow through a cannulated left anterior descending artery in four animals. In all nine animals, subendocardial blood flow was 0.99 +/- 0.21 (ml/min)/g during control and 0.34 +/- 0.14 (ml/min)/g during the most severe grade of underperfusion (p less than 0.001) in the left anterior descending coronary arterial distribution. Regional myocardial lactate release was 0.15 +/- 0.09 and 1.19 +/- 0.75 mumols/ml, respectively (p less than 0.003). A highly significant inverse correlation was observed between subendocardial blood flow and myocardial lactate release during the graded reductions in blood flow (r = -0.71, p less than 0.001). Results from sonomicrometry showed a significant reduction in contractile ventricular function in the anterior wall during the graded reductions in blood flow. The regional arterial-venous glucose difference increased significantly with underperfusion in the left anterior descending coronary arterial distribution, from 0.14 +/- 0.15 to 0.56 +/- 0.37 mumols/ml (p less than 0.003). The contribution of exogenous glucose to lactate release also increased significantly; 0.04 +/- 0.03 mumols/ml of the lactate came from exogenous glucose during control compared with 0.64 +/- 0.59 mumols/ml during the most severe underperfusion (p less than 0.02). A significant positive correlation exists between lactate release and lactate from exogenous glucose during graded underperfusion (r = 0.96, p less than 0.001). In summary, these data demonstrate a close inverse relation between regional myocardial lactate release and regional subendocardial blood flow during graded ischemia.

Inotropic interventions during myocardial "stunning" in the pig.

To study the effects of inotropic interventions on myocardial "stunning," we subjected pigs to 12 minutes of left anterior descendents (LAD) coronary artery occlusion followed by 2 hours of reperfusion. Measurements were made of segmental shortening (SS%), myocardial blood flow (MBF), adenine nucleotides, the extent of ultrastructural damage, and granulocyte accumulation. Three groups of pigs were compared: control (CON) (N = 6), isoproterenol infused (ISO) (N = 6), and pretreated with triiodothyronine (T3) (30 micrograms/kg ip) (N = 5). Inotropic reserve was tested with a bolus of Ca++. During reperfusion, SS% in the CON reperfused segments showed a relatively constant decrement of 75% throughout the reperfusion period but no alteration in the inotropic reserve. In the ISO group, SS% was maintained at preocclusion levels, but there was a small but significant decrease in the inotropic reserve. In the T3 group, SS% was reduced more than 90% and showed no response to the Ca++. Myocardial blood flow was maintained at control levels in the CON and ISO groups during reperfusion but was greatly reduced in the T3 group. The ATP was reduced 36% in CON, 39% in ISO, and further reduced to 87% of control in the T3 group. Mitochondrial damage in the CON and ISO groups was 5 and 10%, respectively, and reversible, but there was 86% irreversible damaged mitochondria in the T3 group. Using a monoclonal antibody against pig granulocytes, the presence and quantitation of adherent granulocytes were determined. There was no accumulation of granulocytes. These data suggest that some forms of myocardial adrenergic augmentation during stunning may have adverse consequences. Thus, the strength, duration, and types of stimulation may be critical to the preservation of the myocardium in the treatment of myocardial stunning.

Effects of drinking and central angiotensin II stimulation on organ blood flow in conscious rats.

While the hemodynamic response pattern accompanying feeding behavior has been well characterized, there is less information about the hemodynamic changes associated with drinking. In the present study, we have measured organ blood flows in conscious, unrestrained rats during schedule-induced drinking behavior, using the tracer microsphere technique (diameter of spheres 15 +/- 3 microns; labels: 141Ce, 113Sn). In addition, we determined the hemodynamic response pattern following intracerebroventricular (i.c.v.) injection of 100 ng angiotensin II (ANG II) (a dose known to be dipsogenic) in rats that were not allowed to drink during the experiment. The hemodynamic responses during drinking behavior included (a) significant increases in blood flow through the kidney, stomach and small intestine, (b) a decrease in blood flow through skeletal muscle, and (c) no significant changes in the rest of the organs. ANG II i.c.v. elicited (a) significant decreases in blood flow through the kidney, stomach, small intestine and skin, (b) a significant increase in blood flow through the liver (hepatic artery), and (c) no significant changes in blood flow through the brain, heart, lung (bronchial arteries), colon, skeletal muscle (biceps) and testis. We conclude that spontaneous drinking behavior in rats is associated with a characteristic hemodynamic drinking response, which resembles a classical feeding reaction. In non-drinking rats the hemodynamic response pattern following ANG II i.c.v. was different from the drinking response, providing further evidence, that the behavioral and cardiovascular effects of the neuropeptide can be dissociated.

Myocardial characteristics of thyroxine stimulated hypertrophy. A structural and functional study.

The effects of thyroxine-stimulated hypertrophy (TSH) were studied in the porcine left ventricular myocardium. Hypertrophy was produced in six adult pigs by administration of triiodothyronine (1 mg/kg; i.v.) for eight days. Six pigs served as controls. The degree of hypertrophy, determined by left ventricular-to-body weight ratio, was 47%. With hypertrophy there was a significant increase in heart rate, blood pressure and myocardial blood flows. Minimal coronary resistance measured during adenosine infusion was lower in the TSH group compared with the control group. Anatomic studies revealed a balanced proliferative response of mitochondria, myofibrils and the t-tubular system during TSH. Analysis of the microvasculature indicated that the capillary and arteriolar beds both experienced growth which paralleled myocyte growth during TSH. These results suggest that thyroxine administration promotes angiogenesis in the microvascular bed which provides a partial anatomic rationale for the lowered minimal coronary resistance.