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Myocardial Ischemia: Mechanisms, Reperfusion, Protection pp 383–407Cite as

The molecular basis of adaptation to ischemia in the heart: The role of stress proteins and anti-oxidants in the ischemic and reperfused heart

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

Abstract

When blood flow to the myocardium is interrupted, for example during a coronary occlusion or coronary artery spasm, the resulting ischemia is characterised by certain metabolic and ultrastructural perturbations including a fall in intracellular pH, decreased ATP levels, decreased glucose levels, increased lactate levels, membrane damage, electromechanical uncoupling and uncoupling of mitochondrial oxidative phosphorylation [1]. This hypoxic phase, with its associated oxygen depletion, therefore leads to significant metabolic stress. When blood flow and, therefore, oxygen are returned to the hypoxic tissue during reperfusion, oxidative stress occurs due to oxygen-derived free radical formation which causes further damage to membranes (via lipid peroxidation), nucleic acids and proteins. In addition, reperfusion is associated with intracellular and mitochondrial calcium overload which causes further damage and uncoupling of respiration and contraction. If ischemia is prolonged, inevitably the changes become irreversible and cell death and tissue necrosis occur.

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Author information

Authors and Affiliations

  1. The Hatter Institute for Cardiovascular Studies, Department of Academic and Clinical Cardiology, University College London Hospital, London, WC1E 6DB, UK

    R. J. Heads & D. M. Yellon

  2. The Medical Molecular Biology Unit, Department of Molecular Pathology, University College London Medical School, London, WC1E 6DB, UK

    D. S. Latchman

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  1. R. J. Heads
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  2. D. S. Latchman
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  3. D. M. Yellon
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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 Berkhäuser Verlag Basel/Switzerland

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Heads, R.J., Latchman, D.S., Yellon, D.M. (1996). The molecular basis of adaptation to ischemia in the heart: The role of stress proteins and anti-oxidants in the ischemic and reperfused heart. In: Karmazyn, M. (eds) Myocardial Ischemia: Mechanisms, Reperfusion, Protection. EXS, vol 76. Birkhäuser Basel. https://doi.org/10.1007/978-3-0348-8988-9_23

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  • DOI: https://doi.org/10.1007/978-3-0348-8988-9_23

  • Publisher Name: Birkhäuser Basel

  • Print ISBN: 978-3-0348-9857-7

  • Online ISBN: 978-3-0348-8988-9

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