Document Detail

Studies on prolonged acute regional ischemia. I. Evidence for preserved cellular viability after 6 hours of coronary occlusion.
MedLine Citation:
PMID:  2739417     Owner:  NLM     Status:  MEDLINE    
Six hours of coronary occlusion has been thought to produce extensive and irreversible transmural damage and no possibility of salvage by reperfusion. This has been based on findings of adenosine triphosphate depletion and histochemical (triphenyltetrazolium chloride nonstaining) and ultrastructural changes (conventional preparatory techniques). This study tests the hypothesis that, in contrast to conventional wisdom, considerable structural and mitochondrial functional integrity remains in cardiac muscle subjected to 6 hours of regional ischemia. Twenty open-chest anesthetized dogs underwent isolation of the left anterior descending coronary artery and were observed for 6 hours. Eight of the 20 did not undergo ischemia and served as controls. Twelve underwent 6 hours of proximal ligation of the left anterior descending coronary artery (30% +/- 2% area at risk). Transmural biopsy specimens were analyzed. Coronary occlusion reduced regional blood flow (radioactive microspheres) to less than 10 ml/100 gm/min (p less than 0.05) and dyskinesia persisted in the area at risk for 6 hours. High-energy phosphates (adenosine triphosphate and creatine phosphate) declined to negligible levels and histochemical damage occurred (49% +/- 12% triphenyltetrazolium chloride non-staining). Mitochondrial ultrastructural changes (low protein denaturation embedding technique) were mild (the integrity of the inner and outer mitochondrial surface membranes and crystal membranes was maintained and myofibrillar degeneration did not occur). Mitochondrial oxidative phosphorylation rate remained at 63% of control levels, respiratory control index remained at 77%, and adenosine diphosphate/oxygen ratio was maintained at 96%. Mitochondrial Ca++ increased with lanthanum (from 26 to 46 nmol/mg protein, p less than 0.05), but irreversible calcium precipitation did not occur; calcium could be mobilized to normal levels (i.e., 13 nmol/mg protein) by ethylenediaminetetraacetic acid chelation. These data support our inference that necrosis does not occur after 6 hours of coronary occlusion and suggest that muscle salvage by reperfusion is possible after at least 6 hours of regional myocardial ischemia.
F Beyersdorf; B S Allen; G D Buckberg; C Acar; F Okamoto; F Sjöstrand; H H Young; H I Bugyi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  98     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1989 Jul 
Date Detail:
Created Date:  1989-08-10     Completed Date:  1989-08-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  112-26     Citation Subset:  AIM; IM    
Division of Cardiothoracic Surgery, UCLA Medical Center 90024-1741.
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MeSH Terms
Adenosine Triphosphate / metabolism
Body Water / metabolism
Calcium / metabolism
Citrate (si)-Synthase / metabolism
Coronary Circulation*
Glucosephosphates / metabolism
Ischemia / metabolism,  pathology
Mitochondria, Heart / metabolism
Myocardium / metabolism,  ultrastructure*
Phosphates / metabolism
Time Factors
Grant Support
Reg. No./Substance:
0/Glucosephosphates; 0/Phosphates; 56-65-5/Adenosine Triphosphate; 7440-70-2/Calcium; EC (si)-Synthase
Comment In:
J Thorac Cardiovasc Surg. 1989 Nov;98(5 Pt 1):796-7   [PMID:  2811416 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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