Chronic alcoholic cardiomyopathy. Protection of the isolated ischaemic working heart by ribose

The effects of ribose on the pre- and post-ischaemic functional performance of the isolated working heart from 24 month old chronically alcoholic animals was investigated. The improved perfusion model permitted the isolated heart to perform work analogous to that of the normal physiological load, in a system where systemic pressure and atrial pressure could be altered over a wide range and oxygen loss from the perfusion fluid was a minimum. There was a remarkable improvement in the performance of isolated hearts taken from alcoholic animals that were perfused with 1.7 mM ribose both before and after a 25.0 min period of global myocardial ischaemia (at 25 degrees C), however ribose treatment did not greatly affect the performance of hearts of isocaloric control aged rats. Chronic alcohol consumption significantly affected heart performance, causing a marked reduction in both cardiac and work output. After ischaemia the work of all hearts was notably decreased; there was no work output in untreated hearts of alcoholic animals, whereas in hearts of alcoholic animals treated with ribose work output was only decreased by 35%. The acute response to ribose by hearts of aged chronically alcoholic animals suggests a role for this compound as a positive inotropic agent and clearly indicates the beneficial potential of ribose for inclusion in cardioplegic solutions or for infusion in alcoholic subjects showing signs of heart failure or chronic heart disease.     

Effect of free radicals in ischaemic renal failure in the dog

After a 30-minute control period ischaemia was evoked in dogs under Nembutal (30 mg/kg, i.v.) anesthesia, by clamping the left renal artery for 45 minutes. This was followed by a 90-minute reperfusion period when diuresis, GFR, PAH clearance, sodium and potassium excretion, malondialdehyde level in the plasma of the renal vein and SOD enzyme activity of the erythrocytes in renal venous blood were determined. Besides the control group (n = 6), the following treated groups were investigated: 1. Allopurinol (n = 7) in a dose of 100 mg/kg, given orally for two days, 2. Silibinin (n = 6) in a dose of 4 mg/kg/hour, given into the renal artery, 3. MTDQ-DS (n = 6) in a dose of 150 mg/kg/hour, given intravenously. 4. SOD (n = 4) 4 mg infusion (initiated 1 minute prior reperfusion). In the first 15-minute period following reperfusion GFR was 21%, cPAH 29% and sodium and potassium excretion 67 and 42% of the values of the contralateral kidney, respectively. Renal function improved gradually during the 90 minutes of reperfusion, and the above-mentioned parameters reached 59, 57, 65 and 76% of the corresponding control data. Increase of malondialdehyde level in the venous blood of the kidney during reperfusion might have been indicative of the production of free radicals; the difference, however, was not significant statistically. The administrations did not lead to considerable change in any of the parameters investigated. No difference could be demonstrated by histological methods between the kidneys of the treated and untreated animals. The compounds studied are thought to be free radical scavengers; in the present work, however, no protective effect could be demonstrated.     

Acylation of dog heart lysophosphatidylserine by transacylase activity

Dog heart microsomes catalyze the transfer of acyl groups from the sn-2 position of phosphatidylcholine (PC) to lysophosphatidylserine (lysoPS) in the presence of coenzyme A (CoA) at pH optima of 4.5-5.0 and 7.5. Acyl transfer activity at acidic pH is about three times higher than at neutral pH. Transacylation of lysoPS by acyl transfer from PC with dog heart microsomes at neutral pH favors arachidonate over linoleate by a factor of 2.1, whereas free linoleic acid is favored by a factor of 3.7 over arachidonic acid for lysoPS acylation in the presence of acyl-CoA-generating cofactors. Considering the location and acyl composition of myocardial PS, it appears that both acyl transfer from PC and utilization of unesterified fatty acids may be involved in the acylation of lysoPS at its sn-2 position.     

Studies of acidosis in the ischaemic heart by phosphorus nuclear magnetic resonance.

1. Phosphorus-nuclear-magnetic-resonance measurements were made on perfused rat hearts at 37 degrees C. 2. With the improved sensitivity obtained by using a wide-bore 4.3 T superconducting magnet, spectra could be recorded in 1 min. 3. The concentrations of ATP, phosphocreatine and Pi and, from the position of the Pi resonance, the intracellular pH (pHi) were measured under a variety of conditions. 4. In a normal perfused heart pHi = 7.05 +/- 0.02 (mean +/- S.E.M. for seven hearts). 5. During global ischaemia pHi drops to 6.2 +/- 0.06 (mean +/- S.E.M.) in 13 min in a pseudoexponential decay with a rate constant of 0.25 min-1. 6. The relation between glycogen content and acidosis in ischaemia is studied in glycogen-depleted hearts. 7. Perfusion of hearts with a buffer containing 100 mM-Hepes before ischaemia gives a significant protective effect on the ischaemic myocardium. Intracellular pH and ATP and phosphocreatine concentrations decline more slowly under these conditions and metabolic recovery is observed on reperfusion after 30min of ischaemia at 37 degrees C. 8. The relation between acidosis and the export of protons is discussed and the significance of glycogenolysis in ischaemic acid production is evaluated.     

Coronary vascular endothelium-myocyte interactions in protection of the heart by ischaemic preconditioning.

Because ischaemia preconditioning is a general phenomenon - it is present in almost all tissues and organs - we must look for a mechanism which involves cell types common to all organs. The hypothesis outlined below is that endothelial cells, in response to a brief ischaemic stimulus, release protective mediators which (in the heart) diffuse to cardiac myocytes to increase resistance to a subsequent ischaemic stress. These substances include nitric oxide, generated through initial bradykinin release, and prostacyclin. The evidence includes measurement of mediator release and the pharmacological attenuation of the antiarrythmic effects of preconditioning by blockade of bradykinin receptors and inhibition of nitric oxide production.     

Travel and ischaemic heart disease.

The hypothesis that travel precipitates acute ischaemic heart disease (IHD) was tested in a case-control study of holidaymakers admitted to hospital in Great Yarmouth. The distance that patients with IHD had travelled to reach Great Yarmouth was on average greater than that travelled by patients with other diseases. I conclude that the greater distances travelled by patients with IHD may have helped to precipitate the attack.     

Influence of short-term hypothermia upon the normal or ischaemic dog kidney.

Dog kidneys were subjected to 1 hr of normothermic ischaemia, maintained for 3 hr in hypothermia with autologous heparinised blood, or underwent a combination of these two treatments and were examined either immediately after the trauma or at different periods up to 1 week after autotransplantation. Clearance tests, tubular amino acid and sugar transport, cortical Na⁺K⁺-ATPase levels, acid phosphatase liberated into the renal circulation, and morphology were investigated. The results obtained (i) confirmed the severe, but slowly and progressively reversible lesion after ischaemia; (ii) revealed the functional impairment with almost normal morphology after hypothermia; and (iii) indicated the immediate and irreparable deterioration of renal function after ischaemic kidneys were subjected to short-term hypothermic treatment of this type.     

Protection of the ischemic diabetic heart by L-propionylcarnitine therapy

Diabetics suffer from an increased incidence of myocardial infarction and are less likely to survive an ischemic insult. Since L-propionylcarnitine (LPC) has been shown to protect against ischemic/reperfusion injury, we hypothesized that LPC may be of even greater benefit to the diabetic heart. Diabetes was induced by i.v. streptozotocin, 60 mg/kg; duration: 12 wks. The chronic effect of LPC was determined by daily i.p. injections (100 mg/kg) for 8 wks. The acute effects of LPC were determined by adding it to the perfusion medium (5 mM) of control and diabetic hearts. Initial cardiac contractile performance of isolated perfused working hearts was assessed by varying left atrial filling pressure. Hearts were then subjected to 90 min of low flow global ischemia followed by 30 min reperfusion. Chronic LPC treatment had no effect on initial cardiac performance in either control or diabetic hearts. Acute addition of LPC to the perfusion medium enhanced pump performance of control hearts, but had no effect in diabetic hearts. Both acute and chronic LPC significantly improved the ability of control and diabetic hearts to recover cardiac contractile performance after ischemia and reperfusion, however, chronic treatment was more effective in diabetic hearts.     

The future of the management of ischaemic heart disease.

Ischaemic heart disease will kill over 150,000 people in the next year in Britain, more than any other single disease process, and cost more than 1.4bn pounds in health care alone. Faced with the continuing problems arising from ischaemic heart disease cardiological clinician scientists are moving from technology based solutions to basic sciences. This article explains how basic science may contribute to new understanding and treatments for patients with ischaemic heart disease. Highlighted are three problems which face any clinical cardiologist on a daily basis and for which basic science may provide solutions: the uncertainty of plaque stability in coronary disease; restenosis after percutaneous transluminal angioplasty; and the shortage of organs for cardiac transplant programmes for patients with heart failure.     

Coronary metabolic adaptation restricted by endothelin in the dog heart.

Endothelin elicits long-lasting vasoconstriction in the coronary bed. This remarkable spastic response raises the question whether or not the metabolic adaptive mechanisms of the coronaries are activated under endothelin effect. The role of the compensatory mediators adenosine and inosine was investigated before and after intracoronary (i.c.) administration of endothelin-1 (ET-1, 1.0 nmol) using 1-min reactive hyperemia (RH) tests on in situ dog hearts (n=15) with or without blocking the ATP-sensitive potassium (K+(ATP)) channels by glibenclamide (GLIB, 1.0 micromol min(-1), i.c.). The release of adenosine and inosine via the coronary sinus was measured by HPLC during the first minute of RH. Endothelin-1 reduced baseline coronary blood flow (CBF) and RH response (hyperemic excess flow (EF) control vs. ET-1: 81.7+/-13.6 vs. 43.4+/-10.9 ml, P<0.01), while it increased the net nucleoside release (adenosine, control vs. ET-1: 58.9+/-20.4 vs. 113.7+/-39.4 nmol, P<0.05; inosine: 242.1+/-81.8 vs. 786.9+/-190.8 nmol, P<0.05). GLIB treatment alone did not change baseline CBF but also reduced RH significantly and increased nucleoside release (EF control vs. GLIB: 72.1+/-11.7 vs. 31.9+/-5.5 ml, P<0.01; adenosine: 18.8+/-4.6 vs. 63.0+/-24.8 nmol, P<0.05; inosine: 113.0+/-37.2 vs. 328.2+/-127.5 nmol, P<0.05). Endothelin-1 on GLIB-treated coronaries further diminished RH and increased nucleoside release (EF: 21.5+/-8.0 ml, P<0.05 vs. GLIB; adenosine: 75.3+/-28.1 nmol, NS; inosine: 801.9+/-196.6 nmol, P<0.05 vs. GLIB). The data show that ET-1 reduces metabolic adaptive capacity of the coronaries, and this phenomenon is due to decreased vascular responsiveness and not to the blockade of ischemic mediator release from the myocardium. The coronary effect of ET-1 may partially be dependent on K+(ATP) channels.