Circulation, Vol 78, 729-735, Copyright © 1988 by American Heart Association
FA Fedele, H Gewirtz, RJ Capone, B Sharaf and AS Most
Limited data are available concerning the effects of mild-to-moderate,
sustained reductions of coronary blood flow on myocardial aerobic
metabolism. This study tested the hypothesis that a sustained flow
reduction distal to a severe coronary artery stenosis may be well tolerated
(after the initial insult is passed) because of gradual improvement in the
balance between myocardial oxygen supply and demand. Studies were performed
in eight sedated, closed-chest domestic swine that were instrumented with
an artificial coronary arterial stenosis (80% diameter reduction).
Hemodynamics, regional myocardial blood flow and oxygen, lactate, acid, and
base metabolism were measured before stenosis and at 5, 20, 60, 120, and
180 minutes after stenosis insertion. Regional myocardial function
(ultrasonic length sensors) was measured serially during 2 hours in three
additional swine. After stenosis placement, endocardial and transmural
flows declined (p less than 0.05) compared with flows before stenosis (from
1.54 +/- 0.37 to 0.73 +/- 0.24 ml/min/g [mean +/- SD] and from 1.44 +/-
0.31 to 1.19 +/- 0.25 ml/min/g, respectively). Thereafter, flows remained
unchanged for the duration of the study. Similarly, prestenosis heart rate
(135 +/- 7 beats/min), aortic mean pressure (113 +/- 17 mm Hg), and tension
time index (27.1 +/- 3.6 mm Hg.sec) remained constant for the duration of
the study. In contrast, regional coronary venous pH declined (p less than
0.05) compared with prestenosis levels (7.35 +/- 0.02) 5 minutes after
stenosis (7.28 +/- 0.04), but it returned to prestenosis levels during the
next hour. Regional coronary venous PCO2 exhibited a similar pattern (i.e.,
acute increase during poststenosis with gradual return to prestenosis
levels).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Metabolic response to prolonged reduction of myocardial blood flow distal to a severe coronary artery stenosis
Department of Medicine, Rhode Island Hospital, Providence, RI 02903.
This article has been cited by other articles:
 |
|
 |
|
  J. D. Schmitto, H. Doerge, H. Post, M. Coulibaly, C. Sellin, A. F. Popov, S. Sossalla, and F. A. Schoendube Progressive right ventricular failure is not explained by myocardial ischemia in a pig model of right ventricular pressure overload Eur. J. Cardiothorac. Surg., February 1, 2009; 35(2): 229 - 234. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Duncker and R. J. Bache Regulation of Coronary Blood Flow During Exercise Physiol Rev, July 1, 2008; 88(3): 1009 - 1086. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Tawakol, R. Q. Migrino, K. S. Aziz, J. Waitkowska, G. Holmvang, N. M. Alpert, J. E. Muller, A. J. Fischman, and H. Gewirtz High-Dose Folic Acid Acutely Improves Coronary Vasodilator Function in Patients With Coronary Artery Disease J. Am. Coll. Cardiol., May 17, 2005; 45(10): 1580 - 1584. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Heusch, R. Schulz, and S. H. Rahimtoola Myocardial hibernation: a delicate balance Am J Physiol Heart Circ Physiol, March 1, 2005; 288(3): H984 - H999. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Vogt, I. Portig, B. Kusch, S. Pankuweit, A. S. Sirat, D. Troitzsch, B. Maisch, and R. Moosdorf Detection of anti-hsp70 immunoglobulin G antibodies indicates better outcome in coronary artery bypass grafting patients suffering from severe preoperative angina Ann. Thorac. Surg., September 1, 2004; 78(3): 883 - 889. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. C. Stanley Myocardial Energy Metabolism During Ischemia and the Mechanisms of Metabolic Therapies Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2004; 9(1_suppl): S31 - S45. [Abstract] [PDF]
|
|
|
|
 |
|
 J. A. Fallavollita, B. J. Malm, and J. M. Canty Jr Hibernating Myocardium Retains Metabolic and Contractile Reserve Despite Regional Reductions in Flow, Function, and Oxygen Consumption at Rest Circ. Res., January 10, 2003; 92(1): 48 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Thomas, J. A. Fallavollita, G. Suzuki, M. Borgers, and J. M. Canty Jr Dissociation of Regional Adaptations to Ischemia and Global Myolysis in an Accelerated Swine Model of Chronic Hibernating Myocardium Circ. Res., November 15, 2002; 91(10): 970 - 977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. Panchal, B. Comte, H. Huang, B. Dudar, B. Roth, M. Chandler, C. Des Rosiers, H. Brunengraber, and W. C. Stanley Acute hibernation decreases myocardial pyruvate carboxylation and citrate release Am J Physiol Heart Circ Physiol, October 1, 2001; 281(4): H1613 - H1620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. C. Hughes, C. K. Landolfo, B. Yin, T. R. DeGrado, R. E. Coleman, K. P. Landolfo, and J. E. Lowe Is chronically dysfunctional yet viable myocardium distal to a severe coronary stenosis hypoperfused? Ann. Thorac. Surg., July 1, 2001; 72(1): 163 - 168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Zhang, K. Ugurbil, A. H. L. From, and R. J. Bache Myocardial oxygenation and high-energy phosphate levels during graded coronary hypoperfusion Am J Physiol Heart Circ Physiol, January 1, 2001; 280(1): H318 - H326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Schulz and G Heusch Hibernating myocardium Heart, December 1, 2000; 84(6): 587 - 594. [Full Text]
|
|
|
|
|
|
J. M. Canty Jr. Nitric Oxide and Short-Term Hibernation : Friend or Foe? Circ. Res., July 21, 2000; 87(2): 85 - 87. [Full Text] [PDF]
|
|
|
|
|
|
J. D. St. Louis, G. C. Hughes, A. P. Kypson, T. R. DeGrado, C. L. Donovan, R. E. Coleman, B. Yin, C. Steenbergen, K. P. Landolfo, and J. E. Lowe An experimental model of chronic myocardial hibernation Ann. Thorac. Surg., May 1, 2000; 69(5): 1351 - 1357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kitakaze, K. Node, T. Minamino, H. Asanuma, T. Kuzuya, and M. Hori A Ca channel blocker, benidipine, increases coronary blood flow and attenuates the severity of myocardial ischemia via NO-dependent mechanisms in dogs J. Am. Coll. Cardiol., January 1, 1999; 33(1): 242 - 249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. HEUSCH Hibernating Myocardium Physiol Rev, October 1, 1998; 78(4): 1055 - 1085. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Martin, R. Schulz, J. Rose, and G. Heusch Inorganic phosphate content and free energy change of ATP hydrolysis in regional short-term hibernating myocardium Cardiovasc Res, August 1, 1998; 39(2): 318 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Wijns, S. F. Vatner, and P. G. Camici Hibernating Myocardium N. Engl. J. Med., July 16, 1998; 339(3): 173 - 181. [Full Text] [PDF]
|
|
|
|
|
|
P. D Verdouw, M. A van den Doel, S. de Zeeuw, and D. J Duncker Animal models in the study of myocardial ischaemia and ischaemic syndromes Cardiovasc Res, July 1, 1998; 39(1): 121 - 135. [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Kloner, R. Bolli, E. Marban, L. Reinlib, and E. Braunwald Medical and Cellular Implications of Stunning, Hibernation, and Preconditioning : An NHLBI Workshop Circulation, May 19, 1998; 97(18): 1848 - 1867. [Full Text] [PDF]
|
|
|
|
|
|
G. Heusch, R. Ferrari, D. J Hearse, T. J.C Ruigrok, and R. Schulz 'Myocardial hibernation'--questions and controversies Cardiovasc Res, December 1, 1997; 36(3): 301 - 309. [Full Text] [PDF]
|
|
|
|
|
|
J.-L. J. Vanoverschelde, W. Wijns, M. Borgers, G. Heyndrickx, C. Depre, W. Flameng, and J. A. Melin Chronic Myocardial Hibernation in Humans: From Bedside to Bench Circulation, April 1, 1997; 95(7): 1961 - 1971. [Full Text]
|
|
|
|
|
|
S. J. Kapadia, J. S. Terlato, and A. S. Most Presence of a Critical Coronary Artery Stenosis Does Not Abolish the Protective Effect of Ischemic Preconditioning Circulation, March 4, 1997; 95(5): 1286 - 1292. [Abstract] [Full Text]
|
|
|
|
|
|
R. Ferrari, A. Cargnoni, P. Bernocchi, E. Pasini, S. Curello, C. Ceconi, and T.J.C. Ruigrok Metabolic Adaptation During a Sequence of No-Flow and Low-Flow Ischemia: A Possible Trigger for Hibernation Circulation, November 15, 1996; 94(10): 2587 - 2596. [Abstract] [Full Text]
|
|
|
|
|
|
H. A. Skopicki, S. A. Abraham, N. J. Weissman, A. K. Mukerjee, N. M. Alpert, A. J. Fischman, M. H. Picard, and H. Gewirtz Factors Influencing Regional Myocardial Contractile Response to Inotropic Stimulation: Analysis in Humans With Stable Ischemic Heart Disease Circulation, August 15, 1996; 94(4): 643 - 650. [Abstract] [Full Text]
|
|
|
|
|
|
B. L. Gerber, J.-L. J. Vanoverschelde, A. Bol, C. Michel, D. Labar, W. Wijns, and J. A. Melin Myocardial Blood Flow, Glucose Uptake, and Recruitment of Inotropic Reserve in Chronic Left Ventricular Ischemic Dysfunction: Implications for the Pathophysiology of Chronic Myocardial Hibernation Circulation, August 15, 1996; 94(4): 651 - 659. [Abstract] [Full Text]
|
|
|
|
|
|
M. Berman, A. J. Fischman, J. Southern, E. Carter, F. Mirecki, H. W. Strauss, A. Nunn, and H. Gewirtz Myocardial Adaptation During and After Sustained, Demand-Induced Ischemia: Observations in Closed-Chest, Domestic Swine Circulation, August 15, 1996; 94(4): 755 - 762. [Abstract] [Full Text]
|
|
|
|
|
|
C. Chen, L. Chen, J. T. Fallon, L. Ma, L. Li, L. Bow, D. Knibbs, R. McKay, L. D. Gillam, and D. D. Waters Functional and Structural Alterations With 24-Hour Myocardial Hibernation and Recovery After Reperfusion: A Pig Model of Myocardial Hibernation Circulation, August 1, 1996; 94(3): 507 - 516. [Abstract] [Full Text]
|
|
|
|
|
|
G. Heusch, J. Rose, A. Skyschally, H. Post, and R. Schulz Calcium Responsiveness in Regional Myocardial Short-term Hibernation and Stunning in the In Situ Porcine Heart : Inotropic Responses to Postextrasystolic Potentiation and Intracoronary Calcium Circulation, April 15, 1996; 93(8): 1556 - 1566. [Abstract] [Full Text]
|
|
|
|
|
|
C. Chen, L. Li, L. L. Chen, J. V. Prada, M. H. Chen, J. T. Fallon, A. E. Weyman, D. Waters, and L. Gillam Incremental Doses of Dobutamine Induce a Biphasic Response in Dysfunctional Left Ventricular Regions Subtending Coronary Stenoses Circulation, August 15, 1995; 92(4): 756 - 766. [Abstract] [Full Text]
|
|
|
|
|
|
R. Schulz, H. Post, S. Sakka, D. R. Wallbridge, and G. Heusch Intraischemic Preconditioning : Increased Tolerance to Sustained Low-Flow Ischemia by a Brief Episode of No-Flow Ischemia Without Intermittent Reperfusion Circ. Res., June 1, 1995; 76(6): 942 - 950. [Abstract] [Full Text]
|
|
|
|
|
|
B. R. Ito Gradual Onset of Myocardial Ischemia Results in Reduced Myocardial Infarction : Association With Reduced Contractile Function and Metabolic Downregulation Circulation, April 1, 1995; 91(7): 2058 - 2070. [Abstract] [Full Text]
|
|