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Bioenergetics, ischemic contracture and reperfusion injury

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Myocardial Ischemia: Mechanisms, Reperfusion, Protection

Part of the book series: EXS ((EXS,volume 76))

Summary

The mammalian heart is normally well oxygenated and anaerobic glycolysis is extremely rare except for the production of extra ATP during extreme exercise like a marathon race. Anaerobic glycolysis plays a role when there is a serious impairment in coronary blood flow such as during heart attack and open heart surgery. The control of glycolysis in ischemic myocardial tissue appears to be extremely complex. During aerobic glycolysis, phosphofructokinase is the most important regulatory enzyme that controls the energy requirements of the cell. Under anaerobic conditions, however, glyceraldehyde-3-phos-phate dehydrogenase becomes the key enzyme because it responds promptly to any changes in the essential supply of co-factors for oxidation. The conversion of pyruvate to acetyl CoA (aerobic metabolism) involves a series of chain reactions primarily catalyzed by pyruvate dehydrogenase complex which is situated at the cross roads between both aerobic and anaerobic glycolysis. It is important to remember that substrate utilization is carefully controlled by substrate availability. During aerobic metabolism, control mechanisms using fatty acids, lactate and glucose as energy substrates regulate the rate of ATP production according to energy demand. This precise mechanism is upset during ischemia and post-is-chemic reperfusion for reasons discussed in this review. The demand for ATP can no longer be met by its supply because of severely reduced anaerobic glycolysis and significantly inhibited ß-oxidation of fatty acids. The impairment of bioenergetics is discussed in the context of several diseases such as cardiomyopathy, heart failure, diabetes, arrhythmias, cardiac surgery, heart-lung transplantation, and also in aging and oxidative stress. The regulation of energy metabolism in preconditioned heart is also discussed. Finally, methods used to preserve energy in ischemic myocardium are summarized and quantitation of the high-energy phosphates is discussed. This review challenges scientists to discover drugs which will stimulate energy supply during myocardial ischemia.

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Authors and Affiliations

  1. Cardiovascular Division, Department of Surgery, University of Connecticut School of Medicine, 06030-1110, Farmington, CT, USA

    D. K. Das & N. Maulik

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  1. D. K. Das
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  2. N. Maulik
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Editors and Affiliations

  1. Department of Pharmacology and Toxicology, University of Western Ontario, Medical Sciences Building, N6A 5C1, London, Ontario, Canada

    Morris Karmazyn PhD (Professor and Career Investigator of the Heart and Stroke Foundation of Ontario) (Professor and Career Investigator of the Heart and Stroke Foundation of Ontario)

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© 1996 Birkhäuser Verlag Basel/Switzerland

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Das, D.K., Maulik, N. (1996). Bioenergetics, ischemic contracture and reperfusion injury. In: Karmazyn, M. (eds) Myocardial Ischemia: Mechanisms, Reperfusion, Protection. EXS, vol 76. Birkhäuser Basel. https://doi.org/10.1007/978-3-0348-8988-9_10

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  • DOI: https://doi.org/10.1007/978-3-0348-8988-9_10

  • Publisher Name: Birkhäuser Basel

  • Print ISBN: 978-3-0348-9857-7

  • Online ISBN: 978-3-0348-8988-9

  • eBook Packages: Springer Book Archive

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