Bioenergy recovery phenomenon in the myocardium following ischemia and factors contributing to the recovery studied by 31P magnetic resonance spectroscopy

Metabolism in ischemic and post-ischemic myocardium was studied by the use of 31P magnetic resonance spectroscopy (31P-MRS) to identify factors that cause recovery of ATP levels in post-ischemic hearts. Perfused guinea-pig hearts were treated to 30 or 60 min of ischemia and reperfused by one of three perfusates, one with 200 μM adenosine (ADO30 for 30 min ischemia), one with 200 μM inosine (INO30 for 30 min ischemia, and INO60 for 60 min ischemia), and the third without adenine uncleoside. After 4 hours of reperfusion, ATP levels in INO30 were 95.5% of preischemic level, and in ADO30, 113.5% at 4 hours. However, ATP levels in the control increased only up to 70.2%. ATP levels in INO60 improved to 73.4% after 4 hours and then became stable. Left ventricular maximal positive dp/dt also recovered to 82.4% (control, 43.1%) after 6 hours. In an in vivo study, ATP levels depressed after ischemia did not recover after 4 hours of reperfusion. However, ATP levels recovered from 70.2% to 86.6% after the administration of adenosine into the left ventricle (0.1 mmol of adenosine per hour) for 2 hours. Administration of inosine or adenosine to the post-ischemic heart should be useful to improve the myocardial metabolism and cardiac function. (author)