[Grönblad-Strandberg syndrome from the angiological viewpoint]

HISTORY AND CLINICAL FINDINGS

A 42-year-old man was admitted for treatment of peripheral vascular disease in the left leg (stage III of Fontaine). A year before he had undergone a right aortofemoral bypass operation. On admission there was stenosis of the left pelvic axis and bilateral femoral artery occlusion. In addition there were changes in the skin with abnormal folds, loss of elasticity and yellowish spots over the sides of the neck and the flexor surfaces of all large joints. In addition vision in the left eye was impaired. These findings suggested connective tissue disease involving the skin, eye and arterial system.

INVESTIGATIONS

Routine haematological tests were normal as were clotting parameters. Serum concentration of GOT, GPT, gamma-GT were slightly increased. There was a dysproteinaemia with raised HDL and LDL levels. Resting electrocardiogram was normal, showing sinus rhythm and left axis deviation. The crurobrachial pressure index was clearly abnormal: 0.6 on the right and 0.5 on the left. Angiography of the pelvic and left arteries revealed long-segment femoral and partial lower-leg occlusions bilaterally. Abdominal sonography indicated diffuse parenchymal calcifications in both kidneys and angioid streaks on bilateral fundoscopy. Skin biopsy showed defects of elastic fibres and perivascular inflammatory infiltration, while capillary microscopy revealed twisting of the capillaries, most of them with normal lumen. These findings taken together indicated pseudoxanthoma elasticum (PXE) or Grönblad-Strandberg syndrome.

TREATMENT AND COURSE

A thrombendarterectomy was performed on the left superficial femoral artery, after which the left popliteal artery became palpable, the pressure indices for the left leg were slightly better, and the patient was discharged home without further complications and improved leg perfusion.

CONCLUSION

Possible cardiovascular involvement had to be taken into account in patients with PXE, and long-term angiological monitoring is indicated.

Effects of adrenaline, administered early or later after ischaemia, and reperfusion on the isolated rat heart

OBJECTIVE

To evaluate the effect of adrenaline on cardiac function when given early or later in the reperfusion period.

DESIGN

Prospective study.

SETTING

University laboratory.

PARTICIPANTS

Wistar rats.

INTERVENTIONS

Isolated rat hearts were subjected to 45 minutes of normothermic ischaemic arrest. During reperfusion, adrenaline was administered early (2 minutes) or later (12 minutes) after termination of ischaemic arrest in addition to a short (5 minutes) or longer (10 minutes) recovery period before function was resumed.

MEASUREMENTS AND RESULTS

Aortic and coronary flow, peak systolic pressure and heart rate were determined before arrest, 10 and 15 minutes after termination of ischaemic arrest. Adenosine triphosphate and creatine phosphate levels were also determined after cardioplegic arrest and reperfusion. Results indicate that early administration of adrenaline was not detrimental but that a longer recovery period after arrest resulted in significantly better cardiac function.

CONCLUSION

After ischaemic arrest of the isolated rat heart a longer recovery period resulted in better cardiac function than a shorter period of recovery.

Ischaemic preconditioning does not protect hypertrophied myocardium against ischaemia

OBJECTIVES

Because ischaemic preconditioning elicits a potent endogenous protective mechanism against the development of myocardial infarction, it is important to explore its utilisation in clinical situations. The aim of this study was to examine whether the myocardium of rats with genetic hypertension could be protected by ischaemic preconditioning.

METHODS

Male New Zealand genetically hypertensive rats (GH-Wistar-derived) and normotensive Wistar controls (WAG-Wistar-derived), aged 12 months, were used. Isolated perfused hearts were preconditioned by 3 periods of 5 minutes' global ischaemia, interspersed with 5 minutes' reperfusion, and subsequently subjected to 25 minutes' global ischaemia, followed by 30 minutes' reperfusion.

RESULTS

Heart and body mass were significantly higher in GH rats. Although the heart/body mass ratios of GH rats were higher than those of WAG rats, the difference was not significant. The reperfusion coronary flow pattern during the preconditioning protocol differed markedly between the 2 groups. Only normotensive WAG hearts demonstrated protective effects of preconditioning on post-ischaemic function and tissue creatine phosphate content, while the GH hearts could not be preconditioned.

CONCLUSIONS

An explanation for the failure of preconditioning in GH hearts is not yet available. The data caution against implementation of preconditioning in patients with angina pectoris and left ventricular hypertrophy.

Characterization of inositolpolyphosphate binding to myocardial membranes

Although it is well-accepted that the phosphatidylinositol signalling transduction pathway, producing inositol-1,4,5-P3 (InsP3) and inositol-1,3,4,5-P4 (InsP4) as second messengers, functions in heart muscle, virtually nothing is known about the roles of the higher inositol polyphosphates such as inositolhexakisphosphate (InsP6). This study demonstrates that InsP6 has the ability to bind intracellularly, with different binding characteristics, to different myocardial membranes. Binding to purified sarcoplasmic reticulum (SR) membranes, purified sarcolemmal (SL) membranes as well as to viable mitochondria were characterized. Binding to all these membranes display high as well as low affinity binding sites, with differing affinities. Kd values of binding to SR were 32 and 383 nM, to SL 61 and 1312 nM, while those of mitochondrial binding were 230 and 2200 nM respectively. InsP4 binding was also investigated and displayed the following characteristics: to SR, one low affinity binding site (Kd = 203 nM) and to SL, a high as well as a low affinity binding site with Kd values of 41 and 2075 nM respectively. Presence of InsP3, the second messenger for SR calcium release, at concentrations of 1 nM, elevated the binding of InsP4 to SR and SL by a mean of 30% and 20% respectively. Fractionation of SR and SL membranes on sucrose density gradients, after solubilization with CHAPS, indicated that InsP6 bound to two separate protein peaks in both these membranes, while InsP4 bound to only one. In SR membranes, InsP4 bound preferentially to a protein separating at high sucrose density while it bound to a protein separating at low sucrose density in SL membranes.

Signal transduction in myocardial ischaemia and reperfusion

Recent studies in the non-ischaemic myocardium indicated that drugs stimulating cAMP formation inhibit alpha 1-mediated inositol phosphate generation, while alpha 1-adrenergic stimulation lowered tissue cAMP levels, implicating cross-talk between alpha 1- and beta-adrenergic signalling pathways in normal physiological conditions. Massive amounts of endogenous catecholamines, predominantly noradrenaline, are released during myocardial ischaemia and reperfusion, causing stimulation of both alpha 1- and beta-adrenergic receptors which, in turn, may contribute to intracellular Ca2+ overload and subsequent cell damage. Since no information is available regarding cross-talk in pathophysiological conditions, the aim of this study was to evaluate the interactions between alpha 1- and beta-adrenergic signalling pathways during different periods of ischaemia and reperfusion. Isolated rat hearts were perfused retrogradely for 30 min before being subjected to (i) 5-25 min global ischaemia and (ii) 1-5 min of reperfusion after 20 min global ischaemia. Drugs (prazosin, 10(-7) M; propranolol, 10(-6) M; phenylephrine 3 x 10(-5) M; isoproterenol 10(-9) M) were added 10 min before the onset of ischaemia and were present during reperfusion. Increasing periods of ischaemia caused an immediate rise and progressive lowering in tissue cAMP and Ins(1,4,5)P3 levels respectively. In contrast, reperfusion caused an elevation in Ins(1,4,5)P3 levels and reduced cAMP. Prazosin elevated cAMP levels during both ischaemia and reperfusion, while propranolol had no effects on tissue Ins(1,4,5)P3. The activity of the alpha 1-adrenergic signal transduction pathway appears to have an inhibitory effect on the activity of the beta-adrenergic system during ischaemia and reperfusion.

No evidence for mediation of ischemic preconditioning by alpha 1-adrenergic signal transduction pathway or protein kinase C in the isolated rat heart

The purpose of this study was to elucidate the role of activation of the alpha 1-adrenergic signal transduction pathway and of protein kinase C (PKC) in the mechanism of protection of functional recovery by ischemic preconditioning in the isolated perfused rat heart. After a stabilization period, nonpreconditioned and preconditioned isolated perfused rat hearts were subjected to sustained ischemia for 25 and 30 minutes of reperfusion. Preconditioning consisted of three episodes of 5 minutes of ischemia, interspersed with 5 minutes of reperfusion. The endpoint was postischemic functional recovery. The effectiveness of preconditioning in the presence of the alpha 1-adrenergic blocker prazosin, the selective PKC blockers chelerythrine and bisindolylmaleimide (BIM), and the ability of repetitive alpha 1-adrenergic activation to mimic preconditioning were compared with the appropriate nonpreconditioned and preconditioned control groups. Alpha 1-adrenergic blockade with prazosin (3 x 10(-7) M) during the preconditioning phase did not abolish the protective effect of preconditioning on functional recovery, and repeated intermittent alpha 1-adrenergic activation with phenylephrine in different concentrations (1 x 10(-8) to 3 x 10(-5) M) did not mimic the protective effect of preconditioning. PKC blockade with the selective PKC inhibitors, chelerythrine (10 microM) and BIM (4 microM), did not abolish the protective effect of preconditioning on functional recovery is isolated perfused rat hearts when given either during the preconditioning phase or shortly before the onset of sustained ischemia. The characteristic metabolic changes of preconditioning during sustained ischemia, namely, energy sparing as manifested in reduced accumulation of lactate, were also not abolished by preconditioning in the presence of selective PKC blockers. We conclude that no evidence could be found for alpha 1-adrenergic or PKC activation in the mechanism of ischemic preconditioning in the isolated rat heart.

A comparison between ischemic preconditioning and anti-adrenergic interventions: cAMP, energy metabolism and functional recovery

OBJECTIVES

The postulate that ischemic preconditioning caused an attenuation in ischemia induced increases in tissue cAMP, and that this may pertain to the mechanism of ischemic preconditioning, was investigated in the isolated rat heart. A significant reduction in tissue cAMP in preconditioned hearts was observed for all time periods of global ischemia studied. The significance of this observation was evaluated by comparing the effect of anti-adrenergic interventions on energy metabolism and post-ischemic functional recovery of both non-preconditioned and preconditioned hearts.

METHODS

The isolated perfused rat heart was used as experimental model. Six groups were studied: Non-preconditioned rat hearts: i) untreated controls (Non-PC), ii) reserpinised (Non-PC Res), iii) propranolol treated (10(-7) M) (Non-PC Prop); Preconditioned rat hearts: iv) preconditioned controls (PC), v) reserpinised (PC Res) and vi) propranolol (10(-7) M) treated (PC Prop).

RESULTS

After 25 min global ischemia the concentration of cAMP was increased by 79.6% in the Non-PC group. This increase was attenuated in all of the treated groups, although in varying degrees. Energy utilization in these hearts also differed markedly between the groups. Functional recovery was however similar in all Non-PC and PC treated groups and significantly superior to that of Non-PC control hearts. Prior reserpinisation mimicked the protective effect of preconditioning on energy metabolism and functional recovery. To determine the significance of attenuation of the increase in cAMP in the protection conferred by preconditioning, hearts were pretreated with forskolin (10(-6) M). This caused an accumulation of tissue cAMP in preconditioned hearts to similar absolute values as seen in untreated non-preconditioned hearts during 25 min global ischemia. However, the percentage increase in forskolin-pretreated preconditioned hearts during sustained ischemia was only 50% vs. 71% in non-preconditioned hearts treated with forskolin, confirming an attenuated beta-response induced by preconditioning. Forskolin treatment of preconditioned hearts did not abolish the protective effect.

CONCLUSIONS

The findings suggest that the protection against ischemic damage conferred by preconditioning is associated with an attenuated beta-adrenergic response. However, whether the changes in cAMP occurring during sustained global ischemia is the cause of consequence of the elicited protection, remains to be established.

Inositolpolyphosphates and their binding proteins--a short review

Since 1983, when it was discovered that inositol 1,4,5-trisphosphate can act as second messenger to release Ca2+ from the endoplasmic reticulum, widespread research has focused on the phosphatidylinositol signalling transduction pathway and the host of inositolphosphates formed intracellularly after stimulation therof. Although the polyphosphates, inositoltetrakisphosphate (InsP4) and inositolhexakisphosphate (InsP6), have received their share of attention, a definite physiological role has not been ascribed to them as yet. Different binding proteins for these two polyphosphates have been demonstrated, especially in brain tissue, indicating their possible importance in the cell. InsP6 is known as one of nature's most powerful antioxidants and has already been demonstrated to possess the abilities to be of use in the industry as well as in the medical profession. As its natural actions are poorly understood and its possible side-effects have not been widely investigated, basic research regarding its cellular and subcellular activities is urgently called for.

Substrate effects on sarcolemmal permeability in the normoxic and hypoxic perfused rat heart

OBJECTIVES

Based on the hypothesis that provision of glucose is good and fatty acids are bad for the ischaemic myocardium, the aims of this study were to determine i) the effects of different substrates on sarcolemmal permeability during normoxia, low-flow hypoxia (HLF) and reperfusion, ii) whether increased membrane permeability is associated with ultrastructural damage and increased influx of Ca2+ into cells and iii) whether changes in membrane permeability correlate with myocardial function and high energy phosphate metabolism.

METHODS

The isolated rat heart subjected to HLF was used as model of global ischaemia, and sarcolemmal permeability assessed by release of LDH from and influx of lanthanum and Ca2+ into myocardial tissue. Myocyte structural injury was also evaluated quantitatively, and mechanical activity was monitored throughout the experimental protocol.

RESULTS

Regardless of the substrate used, HLF caused a 80-90% and 20-40% reduction in myocardial oxygen uptake and coronary flow rate, respectively. Palmitate (0.5 mM conjugated to 0.1 mM albumin) or substrate-free perfusion caused ultrastructural damage and loss of normal sarcolemmal integrity during both normoxia and HLF. Although reperfusion reversed injury in some cells, in general, myocytes exhibited myofibrillar contracture, while membrane integrity recovered to some extent, as indicated by reduced lanthanum influx. Intracellular Ca2+ increased significantly upon reperfusion. Mechanical function as well as tissue high energy phosphates were significantly depressed during both HLF and reperfusion. Glucose, on the other hand, protected against ischaemia-induced structural damage and loss of sarcolemmal integrity. Reperfusion in these experiments resulted in almost complete recovery of normal morphology, ultrastructure and sarcolemmal integrity, while intracellular Ca2+ remained unchanged. Mechanical function and tissue high energy phosphates were significantly higher in glucose-perfused hearts than in palmitate-perfused or substrate-free hearts. Glucose was also able to attenuate the harmful effects of palmitate on myocardial ultrastructure, membrane integrity, mechanical function, energy metabolism and prevented Ca2+ overloading during reperfusion.

CONCLUSION

The results provide new evidence for the protective role of glucose during myocardial ischaemia and reperfusion. Although the exact mechanism of the beneficial actions of glucose remains to be established, the results suggest that glycolytic flux and thus glycolytically derived ATP protect against ischaemic damage via preservation of membrane integrity.

Preconditioning with a single short episode of global ischemia in the isolated working rat heart: effect on structure, mechanical function, and energy metabolism for various durations of sustained global ischemia

PURPOSE

Preconditioning in the setting of global ischemia, using functional recovery during reperfusion as the endpoint, has recently been demonstrated in the isolated perfused rat heart. It has been suggested that its beneficial actions have a metabolic basis. The isolated rat heart has not been fully characterized with respect to the metabolic, functional, and structural changes associated with this phenomenon in the setting of global ischemia. The purpose of this study was to determine (1) the time course of protection conferred by a single episode (5 minutes) of preconditioning; (2) changes in tissue high energy phosphates, lactate, and glycogen levels at different time intervals; and (3) morphological appearance of the heart at the end of ischemia as well as after reperfusion.

METHODS

Isolated perfused working rat hearts were used. Preconditioning consisted of a single episode of 5 minutes of global ischemia and 15 minutes of reperfusion. Preconditioned and non-preconditioned hearts were subjected to global ischemia of 20-35 minutes duration. Functional recovery, energy metabolism (high energy phosphates, lactate, and glycogen), and structural appearance were studied at different stages.

RESULTS

The functional recovery of the preconditioned hearts was significantly higher than in the corresponding nonpreconditioned group during reperfusion for all durations of ischemia longer than 25 minutes. The degree of protection observed was less than reported previously. A minor degree of energy sparing was reflected by differences in the rate of depletion of glycogen and accumulation of tissue lactate during the sustained episode of ischemia. Semiquantitative light microscopy evaluation revealed that ischemia-induced structural damage was less in the preconditioned hearts, both at the end of the sustained ischemic episode as well as after reperfusion.

CONCLUSIONS

A single episode of global ischemia successfully preconditions the isolated working rat heart. The protection elicited was demonstrated on a functional and structural level, and was accompanied by a small energy-sparing effect.

Defective stretch-induced release of atrial natriuretic peptide from aging hypertensive rat heart: possible role of phosphatidylinositol pathway

Because the phosphatidylinositol pathway may be part of the signaling system associated with stretch-induced release of atrial natriuretic peptide (ANP), we tested the hypothesis that formation of the intermediate inositol-1,4,5-trisphosphate (IP3) is impaired when ANP release is decreased in response to atrial stretch in hearts from aging genetically hypertensive (GH) rats. Immunoreactive ANP release into the coronary effluent and IP3 levels were studied in cardiac tissues of isolated perfused hearts from normotensive control (WAG) or GH rats aged 4, 11, or 16 months. Left atria were repeatedly distended and released with a latex balloon. ANP was measured in coronary effluent, and IP3 was measured in cardiac tissues. In all age groups, stretch and relief of stretch evoked considerably less ANP release in spontaneously beating hearts from GH than from WAG rats. Hearts from GH rats aged 16 months released no ANP, but electrical pacing restored some stretch-induced ANP secretion. With repeated stretch and release of stretch of the left atrium for 2 min, IP3 levels increased in left atrial tissue in WAG but not in GH hearts of all age groups. IP3 levels in (unstretched) left ventricles were much lower than in left atria and were unaltered by atrial stretch. In aging GH rats, the capacity to release ANP on atrial stretch is largely lost, in association with complete suppression of stimulus-induced increase in IP3 levels. These data support a role for IP3 in stretch-mediated atrial ANP secretion and suggest a progressive uncoupling of this signaling pathway in aging hypertensive rats.

Effects of ischaemia, reperfusion and alpha 1-adrenergic receptor stimulation on the inositoltrisphosphate receptor population in rat heart atria and ventricles

Binding sites specific for inositol 1,4,5-trisphosphate (InsP3) have been demonstrated in sarcoplasmic reticulum vesicles isolated from heart muscle. Scatchard analysis of a binding isotherm indicated a high as well as a low affinity binding site [1]. In this study a comparison was made between InsP3, binding to crude microsomal membranes prepared from rat heart atria and ventricles respectively. Results obtained showed a four-fold higher incidence of binding to atrial membranes. Furthermore, the receptor populations of the atria and ventricles behaved differently during conditions causing fluctuations in tissue InsP3, levels, viz. ischaemia, reperfusion and alpha 1-adrenergic stimulation. Reperfusion, as well as phenylephrine stimulation, caused an increase in InsP3 levels associated with down-regulation of the ventricular InsP3 receptor population while binding to atrial binding sites was elevated. In the ventricular population this down-regulation was the result of a reduction in Bmax alone with no changes in the Kd values of the high- or the low-affinity binding sites. The reason(s) for the differential response of the atrial and ventricular InsP3 receptor populations to changes in InsP3 levels, remains to be established.

Halothane protects the isolated rat myocardium against excessive total intracellular calcium and structural damage during ischemia and reperfusion

A recent study from our laboratory demonstrated halothane to be a powerful protectant of the isolated rat heart during reperfusion after normothermic cardioplegic arrest. It was speculated that this protective effect might be due to prevention of excessive intracellular calcium. The aim of the present study was to evaluate the effect of halothane on the total intracellular calcium (Ca2+) content and on myocardial structure both at the end of normothermic cardioplegic arrest and at the end of reperfusion. Isolated perfused rat hearts were perfused for a control period of 30 min, followed by 40 min of normothermic cardioplegic arrest with or without reperfusion for 30 min. Halothane (1.5%) was administered continuously before and after arrest. Halothane caused a significant decrease of intracellular Ca2+ at the end of normothermic cardioplegic arrest and after reperfusion. Myocardial morphology was assessed by extensive light microscopy and ultrastructure was evaluated by electron microscopy. Grading of ischemic damage showed that exposure to normothermic cardioplegia resulted in marked ischemic injury, regardless of whether the hearts were treated with halothane. Reperfusion in the presence of halothane caused a significant reversal of ischemic damage and almost complete ultrastructural repair, whereas untreated hearts still exhibited severe edema, contracture, and contracture bands. Our results indicate that the beneficial effects of halothane on myocardial structural recovery during reperfusion is associated with a reduction in excessive intracellular Ca2+. The exact mechanism of this protective action is under investigation.

Preconditioning with hypoxia versus global ischemia in the isolated rat heart: effect on function and metabolism

It has recently been shown that hypoxia and ischemia are equally effective to precondition the myocardium of the rat. A comparison of the metabolic changes caused by transient ischemia and hypoxia has not yet been made and may help to elucidate the metabolic factors involved in eliciting preconditioning. The aim of this study was to compare the changes in tissue high energy phosphates, glycogen and lactate during and after hypoxic and ischemic preconditioning in isolated perfused rat hearts. Isolated rat hearts were subjected to global ischemia of 30 minutes duration, with and without preconditioning consisting of a single episode of 5 minutes global ischemia or hypoxia (PO2 = 12kPa). The post-ischemic recovery of aortic flow of the nonpreconditioned group was significantly less than that of the two preconditioned groups: 0.5 +/- 0.5 ml/min vs. 23.3 +/- 3.4 and 20.7 +/- 3.6 ml/min for ischemic and hypoxic preconditioning respectively. The only common metabolic factor between the two preconditioned groups was the similar extent of glycogenolysis after transient ischemia or hypoxia: glycogen decreased from 22 +/- 0.8 in non-preconditioned hearts to 16 +/- 0.5 and 16 +/- 1.5 mumoles glucose per g wet tissue in ischemic and hypoxic preconditioned hearts respectively. There was also no difference in lactate production between the two groups during the sustained episode of ischemia. We conclude that oxygen deprivation, rather than other metabolic factors, is the important factor in eliciting preconditioning.

Demonstration of a specific [3H]INS(1,4,5)P3 binding site in rat heart sarcoplasmic reticulum

Previous studies have suggested that inositol(1,4,5)-trisphosphate (InsP3) might induce release of Ca2+ by sarcoplasmic reticulum (SR) vesicles isolated from heart muscle. In this study binding sites specific for InsP3 in isolated SR vesicles from heart muscle were demonstrated. Scatchard analysis of a binding isotherm indicated two binding sites, viz a high affinity site with a Kd = 20 nM and Bmax = 4.2 pmol/mg protein and a low affinity site with a Kd = 424 nM and Bmax = 31 pmol/mg protein. Specificity of binding was demonstrated by using structural analogues. In addition to the finding of binding sites for InsP3, this membrane preparation also demonstrated a possible binding site for InsP4.

Effects of beta-blockers and Ca(2+)-antagonists on the response of the isolated working rat heart to adrenergic stimulants after cardioplegic arrest

During coronary artery bypass graft (CABG) surgery, patients pretreated with the combination of beta-blocking drugs and Ca2+ antagonists for control of myocardial ischemia often respond inadequately to adrenergic stimulants administered after cardioplegic arrest. In this study, the effects of the combination of a beta-blocker (propranolol) and a Ca2+ antagonist (nifedipine) on the spontaneous recovery, as well as the adrenergic response of the isolated, perfused, working rat heart after a period of cardioplegic arrest were evaluated. After pretreatment of the animals with propranolol and/or nifedipine, hearts were removed, perfused in the presence of pretreatment drugs, subjected to 45 minutes of normothermic cardioplegic arrest, reperfused, and finally stimulated with exponentially increasing concentrations of a sympathomimetic drug. Propranolol, and to a lesser extent nifedipine, protected the hearts during cardioplegic arrest, as indicated by the improved recovery and maximum response to adrenergic stimulation after cardioplegia. Isoprenaline, a beta-stimulant, (at a 100 x higher than conventional concentration), elicited an adequate inotropic and chronotropic response. Stimulation by the alpha, beta-stimulant adrenaline or dobutamine improved only the inotropic response of propranolol and combination treated hearts. Cautious extrapolation of the results to human may suggest continuation of drug therapy of patients before CABG surgery.

Free radical effects on myocardial membrane microviscosity

Previous studies have shown that myocardial membranes, isolated from ischemic myocardial tissue, showed marked changes in microviscosity. To evaluate the contribution of free radical production and concomitant lipid peroxidation to these changes in microviscosity, the in vitro effects of two radical producing systems (H2O2/FeCl2 and xanthine oxidase/hypoxanthine/FeCl3) were investigated separately on the microviscosity of sarcolemmal, mitochondrial and sarcoplasmic reticulum membranes. In all three membranes both these free radical producing systems caused formation of malondialdehyde as quantitated by the thiobarbituric acid test. The sensitivity of the membranes to free radical damage differed: the sarcolemma was more sensitive to H2O2 damage, while mitochondrial malondialdehyde production was highest with xanthine oxidase. H2O2/FeCl2 caused a reduction in microviscosity (i.e. increased fluidity) of all three membranes, whereas the xanthine oxidase system increased mitochondrial and sarcolemmal microviscosity and reduced that of the sarcoplasmic reticulum. The similarity between ischemia-induced membrane microviscosity changes and those induced in vitro by xanthine oxidase, indicate a possible causal role for superoxide and hydroxyl free radicals produced during ischemia.

Radiation-induced damage of the Wistar rat heart: biochemistry and function

A time sequence study was performed on Wistar rats to investigate the early effects of radiation on the mechanical function and energy metabolism of the heart. Two series of rats were exposed to 20 Gy electron irradiation to a field including the heart and approximately a third of the lungs. The hearts were excised at varying time intervals (8-180 days) post irradiation. In one series of hearts the mechanical function was measured using the isolated perfused working rat heart model. At the end of the perfusion the hearts were freeze-clamped for analysis of the high energy phosphate contents (ATP, ADP, AMP and creatine phosphate). In the second series, mitochondria were isolated and the oxidative phosphorylation function measured polarographically (substrate: glutamate). Maximal depression of mechanical function was observed at 60 days post irradiation. Thereafter the work performance of these hearts improved significantly, almost reaching control levels after 180 days. The mitochondrial oxidative phosphorylation function (as measured on the total mitochondrial population) was significantly depressed 30-120 days post irradiation. As in the case of the mechanical changes, the depression was transient and after 180 days post irradiation, values similar to those of controls were obtained. Myocardial high energy phosphates remained unaltered throughout the experiment.

[Osteomalacia caused by malabsorption]

Reports on sickness osteomalacia are relatively rare in Europe. Distinction from other painful illnesses of the locomotor system is difficult. A case of osteomalacia has been reported which was caused by a primarily biliary cirrhosis of the liver as well as by chronic cholecystitis and pancreatitis.

Ro 5-4864 and PK 11195, but not diazepam, depress cardiac function in an isolated working rat heart model

The present study was designed to investigate the effects of diazepam, a benzodiazepine (BZ) with high affinity to central BZ receptors and moderate affinity to mitochondrial BZ receptors, and of Ro 5-4864 and PK 11195, ligands specific for mitochondrial BZ receptors, on cardiac function in the isolated working rat heart model. Five concentrations of these drugs (10(-9)-10(-5) mol/l) were used, and the chronotropic (heart rate) and inotropic [maximum elastance of the left ventricle at end systole (Emax), maximal first derivative of left ventricular (LV) pressure (dP/dtmax), LV pressure at dP/dtmax (pressure at dP/dtmax), aortic flow, stroke work, and total pressure-volume area] cardiac parameters were measured. Diazepam, Ro 5-4864, and PK 11195 showed no significant chronotropic activity up to 10(-5) mol/l. Diazepam did not alter the inotropic properties of the heart. Ro 5-4864 at 10(-5) mol/l significantly decreased the indices of contractility, namely, Emax, dP/dtmax, and pressure at dP/dtmax. Aortic flow, stroke work, and total pressure-volume area were significantly depressed at the same concentration. The negative inotropism of PK 11195 appeared to be identical, by most indices, to that of Ro 5-4864, both qualitatively (same pattern) and quantitatively (similar maximal variations); however, for some indices a depressant effect was also found at 10(-7) mol/l. These results show that at high concentrations Ro 5-4864 and PK 11195, but not diazepam, have a depressant effect on mechanical function.

Enflurane and isoflurane reduce reperfusion dysfunction in the isolated rat heart

We evaluated the possible cardioprotective effects of enflurane (E) and isoflurane (I) in isolated rat hearts subjected to 40 min normothermic arrest. After reperfusion, hearts were stimulated with adrenaline to evaluate their systolic reserves. In hearts not receiving I or E, adenosine triphosphate (ATP) was reduced from 23.0 +/- 0.8 to 9.3 +/- 1.1 mumol/g dry weight (means +/- SEM; P < 0.001) after arrest. This was associated with a significant reduction in ventricular work (Wt) from 13.6 +/- 0.7 to 1.6 +/- 0.7 mW (P < 0.001). Adrenaline partially restored Wt but not the ATP. E and I given only during normothermic arrest (in the cardioplegic solution) resulted in reductions in ATP similar to the hearts not receiving the drugs. However, on reperfusion and subsequent administration of adrenaline, hearts subjected to the anesthetic drugs performed as well as hearts before arrest. For example, in hearts not exposed to I or E, the Wt after the elective arrest was 1.55 +/- 0.05% (mean +/- SEM) of the pre-arrest value. This was significantly less than hearts exposed to either one of the inhalational agents (40.02 +/- 3.49% of the pre-arrest value; P < 0.0001). Adrenaline improved function in hearts which did not receive I or E to 55.02 +/- 12.80% of the pre-arrest value, but this was significantly less than the Wt performed by the hearts exposed to the anesthetic agents (122.67 +/- 7.78% of pre-arrest value; P < 0.001). This beneficial effect of I and E during reperfusion probably is mediated by the effect of the anesthetic agents on Ca2+ slow channels. The effect could not be ascribed to depression of global myocardial contractile function associated with I and E.

Effect of captopril on changes in rats' hearts induced by long-term irradiation

The aim of this study was to test the efficacy of captopril, an angiotensin-converting enzyme inhibitor and a known suppressor of fibrosis, in preventing late radiation-induced cardiac pathology. Myocardial functional, histochemical and ultrastructural-morphometric studies were done on perfused hearts of rats isolated 3 and 6 months after 60Co gamma irradiation with 20 Gy and age-matched controls. At each time the animals were divided into the following groups: nonirradiated controls; irradiated once with 20 Gy; irradiated as above and given daily doses of captopril; daily doses of captopril without irradiation. The results showed that captopril, while ameliorating the decrease in the indices of capillary function, increase in mast cells, fibrosis, number of atrial granules, and changes in nerve terminals, failed to prevent the progressive functional deterioration of the hearts after irradiation. These findings suggest that an intramyofiber derangement may be involved in the long-term myocardial complications of irradiation.

The effect of ischaemia-reperfusion on [3H]inositol phosphates and ins(1,4,5)P3 levels in cardiac atria and ventricles--a comparative study

In this study incorporation of [3H]inositol into inositol phosphates and phosphoinositides as well as tissue Ins(1,4,5)P3 levels of the atria and ventricles of isolated, perfused rat hearts were compared. Although the incorporation of [3H]inositol into the phosphoinositides of atria and ventricles was similar, significantly higher (2-3 fold) incorporation rates into inositol phosphates were observed in atrial tissue. Using a D-myo-[3H]Ins(1,4,5)P3 assay system, the Ins(1,4,5)P3 levels observed in atria from perfused rat hearts were also significantly higher than those obtained under the same experimental circumstances in the ventricles. Since previous studies on whole hearts showed inhibition of the phosphatidylinositol (PI) pathway during ischaemia with an immediate significant stimulation upon reperfusion [12, 20], the effects of ischaemia and 1 min postischaemic reperfusion were also examined separately in atria and ventricles. The results showed that 20 min of global ischaemia significantly depressed Ins(1,4,5)P3 levels as well as incorporation of [3H]inositol into ventricular InsP2 and InsP3. Reperfusion caused an immediate (within 1 min) increase in Ins(1,4,5)P3 levels and also [3H]inositol incorporation into all three cytosolic inositol phosphates in the ventricles. However, the effect of ischaemia and reperfusion on Ins(1,4,5)P3 levels as well as the incorporation of [3H]inositol into the inositol phosphates were less prominent in the atria. It therefore appears that the differential responses of the atria and the ventricles to an oxygen deficiency [41] are also reflected in the differences in PI metabolism during ischaemia-reperfusion.

The role of alpha 1-adrenergic stimulation in inositol phosphate metabolism during post-ischaemic reperfusion

The aim of this study was to elucidate the mechanism of enhanced inositol phosphate metabolism during reperfusion. Inositol phosphate stores were prelabelled by perfusing isolated rat hearts for 1 h with [3H]inositol (1.5 microCi/ml). LiCl (10 mM) and prazosin (0.3 microM) were subsequently added 15 min before (i) 20 min control perfusion; (ii) 20 min normothermic ischaemic cardiac arrest (NICA); (iii) 20 min NICA followed by 1 min reperfusion. The ventricles were freeze-clamped before determination of isotopical incorporation of [3H]inositol into the inositol phosphates (Dowex anion exchange chromatography) and InsP3 levels (Amersham InsP3 assay system). In addition, noradrenaline release into the perfusate was also assessed (HPLC and electrochemical detection). The results showed: (i) increased noradrenaline release into the perfusate immediately after the onset of reperfusion; (ii) significant depression of [3H]inositol incorporation into inositol phosphates and InsP3 levels after 20 min NICA; (iii) reperfusion caused an immediate significant increase in isotopical incorporation of [3H]inositol into inositol phosphates as well as InsP3 levels; (iv) the alpha 1-adrenergic blocker, prazosin (0.3 microM), completely inhibited the reperfusion-induced increase in inositol phosphate metabolism. These observations suggested that increased alpha 1-adrenergic receptor stimulation by noradrenaline might be responsible for the stimulation of ventricular inositol phosphate metabolism during postischaemic reperfusion.

Halothane does have protective properties in the isolated ischemic rat heart

To determine whether halothane has protective effects on the ischemic heart, the influence of various concentrations (0.5%-1.5%) of halothane on metabolic and functional recovery during reperfusion after 60-min hypothermic (20 degrees C) and 40-min normothermic cardioplegic arrest was determined in the isolated rat heart. Halothane was administered either before and after arrest or intermittently during arrest. Hearts not receiving halothane demonstrated a reduction in adenosine triphosphate (ATP) content from a control value of 20.35 +/- 1.66 mumol/g dry wt (mean +/- SEM) (before arrest) to 9.34 +/- 1.12 mumol/g dry wt at the end of arrest (P less than 0.001). The myocardial ATP content, when measured 20 min after arrest and during reperfusion, remained decreased (9.57 +/- 0.62 mumol/g dry wt). Under these experimental conditions, aortic flow was reduced from 43.62 +/- 2.40 mL/min before arrest to 1.80 +/- 1.80 mL/min 20 min after arrest and during reperfusion (P less than 0.001). The administration of adrenaline after 20 min of reperfusion resulted in partial recovery to 22.01 +/- 8.36 mL/min. Administration of halothane (0.5%) before the cardioplegic period was associated with a reduction of ATP at the end of the normothermic arrest (4.02 +/- 0.38 mumol/g dry wt; P less than 0.01), but the ATP increased significantly (13.45 +/- 0.32 mumol/g dry wt) when measured after the arrest and after 20 min of reperfusion and stimulation with adrenaline.(ABSTRACT TRUNCATED AT 250 WORDS)

Myocardial membrane cholesterol: effects of ischaemia

Evidence has recently been presented that myocardial ischaemia is associated with a significant increased mitochondrial cholesterol content, suggesting a redistribution of cholesterol within the ischaemic cell (Rouslin et al. 1980, 1982). The aim of this study was therefore to determine the effects of different periods of ischaemia and reperfusion on the cholesterol content of myocardial mitochondria, sarcoplasmic reticulum and sarcolemma. Using the isolated perfused rat heart as experimental model, it was demonstrated that increasing periods of ischaemia (15-60 min) caused a progressive loss of cholesterol from the tissue as well as from the sarcolemma and sarcoplasmic reticulum, concomitant with a significant increase in mitochondrial cholesterol content. These compositional changes were associated with a marked increase in sarcolemmal and mitochondrial microviscosity, while that of the sarcoplasmic reticulum was reduced. To gain more insight into the mechanisms controlling intracellular cholesterol distribution, control and ischaemic hearts were perfused with either exogenous cholesterol or its precursor [U-14C]acetate as an indicator of endogenous cholesterol synthesis. Perfusion with exogenous cholesterol resulted in significant increases in the membrane cholesterol content of control hearts. However, hypoxic, low flow perfusion prevented cholesterol enrichment of the sarcolemmal and sarcoplasmic reticulum membranes, while the cholesterol content of the mitochondria was increased from 99.48 +/- 12.75 to 127.61 +/- 1.84 nmols/mg protein, indicating specific incorporation into this membrane system. Incorporation of [U-14C]acetate into cholesterol in the sarcoplasmic reticulum was increased by 120% in ischaemic conditions. However, a marked redistribution of newly synthesized cholesterol was observed within the ischaemic cell: under control conditions most of the labelled cholesterol was transferred to the sarcolemma and least to the mitochondria, while this distribution pattern was reversed in ischaemia. In view of the fact that exchange of cholesterol between membranes is affected by both phospholipid polar head-group composition and acyl chain length and saturation, it is suggested that prior ischaemia-induced membrane compositional changes might lead to intracellular cholesterol redistribution. Finally, to determine whether cholesterol loss affects sarcolemmal permeability, hearts enriched in sarcolemmal cholesterol were subjected to 15 or 30 min global ischaemia followed by reperfusion and the rate of enzyme release determined. However, enzyme release was similar in treated and untreated hearts, indicating that sarcolemmal cholesterol loss probably does not affect its permeability.

The effect of ischaemia and reperfusion on sarcolemmal inositol phospholipid and cytosolic inositol phosphate metabolism in the isolated perfused rat heart

In this study the mass of polyphosphoinositides as well as the turnover of [3H]inositol phospholipids and [3H]inositol phosphates during ischaemia and short periods of reperfusion were studied in the isolated perfused rat heart. Since the phosphoinositides located within the sarcolemma are precursors for release of inositoltrisphosphate (InsP3) and diacylglycerol, sarcolemmal membranes (rather than whole tissue) isolated at the end of the experimental procedure, were used. Hearts were prelabelled with [3H]inositol and subsequently perfused with 10 mM LiCl to block the phosphatidylinositol (PI) pathway. The results showed that 20 min of global ischaemia depressed the amount of [3H]inositol present in both sarcolemmal phosphatidylinositol-4-phosphate (PI-4-P) and phsophatidylinositol-4,5-bisphosphate (PI-4,5-P2), as well as in the cytosolic [3H]inositol phosphates, [3H]InsP2 and [3H]InsP3. The mass of the sarcolemmal inositol phospholipids remained unchanged during ischaemia. Reperfusion caused an immediate (within 30 sec) increase in the amount of [3H]inositol in sarcolemmal PI, PI-4-P and PI-4,5-P2. PI-4-P levels showed a transient increase after 30 seconds postischaemic reperfusion, while the mass of the other sarcolemmal inositol phospholipids, PI and PI-4,5-P2, remained unchanged. [3H]InsP, [3H]InsP2 and [3H]InsP3 also increased significantly in comparison to ischaemic hearts after only 30 sec postischaemic reperfusion. In summary, the results obtained indicate inhibition of the PI pathway during ischaemia with an immediate significant stimulation upon reperfusion. In view of the capacity of InsP3 to mobilize Ca2+, the possibility exists that stimulation of this pathway during reperfusion may play a role in the intracellular Ca2+ overload, characteristic of postischaemic reperfusion.

Testosterone and cyproterone acetate modulate peripheral but not central benzodiazepine receptors in rats

Sixteen days of testosterone acetate (TA) treatment in male rats induced an increase in the densities of peripheral benzodiazepine receptors (PBR) in the adrenal and Cowper's glands and a decrease in PBR density in the testis. TA did not alter PBR density in the heart, cerebral cortex, or pituitary, or central benzodiazepine receptor (CBR) density in the cerebral cortex or hypothalamus. The antiandrogenic agent cyproterone acetate induced a decrease in PBR density in the testis, adrenal, and pituitary, but did not affect PBR density in Cowper's glands, heart, or cerebral cortex, or CBR density in the cerebral cortex or hypothalamus. In all of the above organs, affinity values did not change following the treatment with both agents. The receptoral changes may be relevant to the physiological and neurobehavioral effects of the chronic exogenous androgenic and antiandrogenic treatment.

Increased myocardial inositol trisphosphate levels during alpha 1-adrenergic stimulation and reperfusion of ischaemic rat heart

Although stimulated [3H] inositol phosphate turnover has been demonstrated in isolated, perfused [3H] inositol prelabelled rat hearts, there is still no information regarding Ins (1,4,5)P3 levels in intact cardiac muscle. Using a D-myo-Ins(1,4,5)P3 assay system, Ins(1,4,5)P3 levels were determined in isolated perfused rats hearts during ischaemia, reperfusion and alpha 1-adrenergic stimulation via noradrenaline (3 x 10(-5) M). Control hearts contained +/- 674 pmols Ins(1,4,5)P3/g dry heart weight. Myocardial Ins(1,4,5)P3 levels were significantly decreased (+/- 389 pmols/g dry heart weight) after exposure to 20 mins of normothermic ischaemic cardiac arrest (NICA). Reperfusion produced a marked increase in Ins(1,4,5,)P3 levels (+/- 1,115 pmols/g dry heart weight) after only 30 s. Noradrenaline caused a 3-4 fold increase in tissue Ins(1,4,5)P3 levels within 30 s. After 20 mins stimulation with noradrenaline, the Ins(1,4,5)P3 levels were still significantly elevated. The rise in tissue Ins(1,4,5)P3 levels during reperfusion as well as during noradrenaline administration was counteracted by neomycin (0.5 x 10(-3) M), an inhibitor of phosphoinositidase specific phospholipase C. In both events neomycin restored the Ins(1,4,5)P3 levels to control values. For correlation of tissue Ins(1,4,5)P3 levels with mechanical events, noradrenaline (3 x 10(-5) M), in the presence of 10 mM LiCl, 10(-7) M propranolol and 10(-7) M atropine, was administered to isolated perfused rat hearts and the mechanical performance recorded over a period of 20 mins. Noradrenaline caused a significant increase in peak systolic pressure and work performance which was maintained for at least 10 mins, suggesting that the positive inotropic effects of noradrenaline may be provoked by Ins(1,4,5)P3. Furthermore, the finding that 20 min NICA followed by 30 s reperfusion causes an immediate significant increase in Ins(1,4,5)P3 content suggests a role for the phosphatidylinositol pathway in the intracellular Ca2+ overloading, characteristic of ischaemia-reperfusion.

Oxygenation of cardioplegic solutions: a note of caution

The merits of oxygenated crystalloid cardioplegic solutions have been well established in experimental animals. The positive effects of oxygenation of Plasmalyte B (Sabax Ltd) and St. Thomas Hospital solution (Plegisol) were achieved by gassing with 95% O2/5% CO2 and 100% O2, respectively. In view of the marked pH differences induced by these gas mixtures, we evaluated the effect of mode of oxygenation on myocardial recovery during reperfusion after hypothermic cardioplegic arrest. Oxygenation with 100% O2 of Plasmalyte B containing high K+ levels caused marked deterioration in myocardial recovery, whereas the mode of oxygenation did not affect recovery after arrest with St. Thomas Hospital solution. Because the major differences between these solutions reside in their respective K+, Mg2+, and HCO3- contents, the effects of variations in the levels of these ions were investigated. The results showed that oxygenation with 100% O2 was deleterious only in the presence of high K+ (29 mmol/L), low Mg2+ (3 mmol/L), and high NaHCO3 (28 mmol/L) levels. The marked decline in mechanical recovery during reperfusion was associated with significant changes in myocardial adenosine triphosphate and intracellular Ca2+ levels. Although an explanation for these findings is not readily available, it is suggested that complex ionic interactions and possibly oxygen free radical generation may lead to intracellular Ca2+ overload, depression in mitochondrial adenosine triphosphate generation, and, hence, deterioration in mechanical recovery.

Preservation of myocardial function and biochemistry after blood and oxygenated crystalloid cardioplegia during cardiac arrest

We compared the ability of blood cardioplegia and oxygenated crystalloid cardioplegic solutions to maintain regional left ventricle contractility and adenosine triphosphate levels after cardiopulmonary bypass. Ten baboons were subjected to 90-minute cardiopulmonary bypass conducted at 28 degrees C. Hemodynamic measurements were made before and after the bypass procedure, and biopsies for high-energy phosphate determinations were performed at different time intervals during and after bypass. The results showed improved maintenance of myocardial contractility (measured with the regional end-systolic pressure-length relationship) with the oxygenated crystalloid solution. Expressed as a percentage of values before bypass, contractility after bypass averaged 81.69% +/- 4.81% and 80.47% +/- 10.05%, respectively, after 10 and 20 minutes using the oxygenated crystalloid cardioplegia. For blood cardioplegia, the corresponding values were 71.9% +/- 8.73% and 64.99% +/- 8.60% (mean +/- standard error of the mean). The 10- and 20-minute postbypass values between the two groups differed significantly (t test, Welch modification: p = 0.0464 and p = 0.0342). Myocardial adenosine triphosphate level was higher immediately after induction of cardiac arrest when blood cardioplegia was used (blood cardioplegia, 6.82 mol.g wet wt-1; crystalloid cardioplegia, 4.95 mol.g wet wt-1; p = 0.0314), but values subsequently equalized.

Glycosphingolipid expression on murine L1-fibrosarcoma cells: analysis of clonal in vivo and in vitro selected sublines with different lung colonisation potential

The patterns of acidic and neutral glycosphingolipids (GSLs) were examined in a syngeneic tumour system in Balb/c mice consisting of closely related cell lines with different colonisation potentials directed to the murine lungs (in vivo selected highly metastatic sublines of L1-fibrosarcoma cells and their WGA-resistant mutants with low metastatic potential). GSLs were analysed by high-performance thin-layer chromatography and structurally identified by fast atom bombardment mass spectrometry combined with compositional analyses and exo-glycosidase digestion. The results suggest that highly metastatic sublines L1-LM and L1-LM12 derived by in vivo selection from mouse fibrosarcoma cells (cell line L1) exhibit a drastic increase of polar ganglioside expression and a restriction to globo-series GSLs. Contrasting with this the low metastatic mutant cells (L1-LM13WGA) express a reduced portion of acidic GSLs and exhibit a shift to less polar ganglioside components. Total cellular and plasma membrane-integrated GSLs were demonstrated to exhibit largely identical patterns. Concomitant with a significant decrease in LacCer expression a substantial reduction of GM2 and a complete lack of GM3 expression can be assigned to the highly metastatic sublines of L1-cells. On the other hand, the more polar gangliosides GM1a and, to an even greater extent, GD1a (exceeding 70% of total gangliosides) accumulate on L1-LM and their clonal sublines. The shift to acidic GSLs of higher polarity is less pronounced on the low metastatic WGA-resistant mutant cells (L1-LM13WGA) showing a preponderance of GM1a. The portion of GD1a within the fractions of acidic GSLs does not correspond to the cellular activities of CMP-NeuAc/GM1 (alpha 2-3) sialyltransferase measured for high and low metastatic cell variants. Total sialic acid content of the various cell lines differs, but is not associated with the metastatic potential. Gangliosides on L1-cells exhibit a significant substitution of N-glycolyl for N-acetylneuraminic acid (13%) compared to their metastatic sublines and to mutant cells (less than 1%). A conversion of surface exposed GD1a to GM1a on membranes of metastatic cells by in situ treatment with Vibrio cholerae sialidase is associated with a significant reduction of tumour cell colonisation directed to the murine lungs.

Lanthanum probing of cell membrane permeability in the rat heart: pathological versus artefactual alterations

The influence of fixation on membrane permeability has been examined in the isolated rat heart using lanthanum as a permeability probe. Normal and ischaemic hearts were probed at various stages during a conventional fixation programme with either ionic or colloidal lanthanum and compared with lanthanum saline administered prior to fixation. Fixation of the myocardium coincident with or followed by lanthanum probing resulted in an influx of the probe into most myocytes in normal tissue. Alterations in permeability after ischaemic episodes could not be distinguished from the artefact. However, lanthanum saline prior to fixation showed exclusion of the probe from normal tissue, while the increased permeability demonstrated after ischaemia was associated with declining myocardial performance during subsequent reperfusion. These results illustrate the need for caution in the application and evaluation of methods determining permeability in fixed tissue. Probes of differing size and charge permeated fixed tissue to varying degrees thereby implicating the formation of specific lesions during chemical fixation.

Radiation-induced changes in the ultrastructure and mechanical function of the rat heart

A time sequence study was performed to study the early effects of radiation on the ultrastructure of the rat heart. Wistar rats were exposed to 20 Gy electron irradiation to a field including the heart and a third of the lung. The hearts were excised at varying time intervals (1 h-180 days), and the ultrastructure of perfusion-fixed subepicardium and subendocardium studied. Changes were observed in both myocytes and interstitium at all time intervals. The most pronounced change observed in the myocyte was that of intercalated disc damage which reached a peak at 30 days post-irradiation. Mitochondrial damage, characterized by swelling and fenestration in areas of myofibrillar contracture, was focal and relatively scarce. Swelling of the capillary endothelial cells and collapse of the capillaries were marked up to 60 days. Of significance was the observation that the damage to both myocytes and interstitium receded after 60 days and the hearts exhibited an almost normal ultrastructure from 100 to 180 days post-irradiation. Mechanical function of these hearts followed a similar pattern: maximal depression was observed 60 days after irradiation. Thereafter the work performance of these hearts improved significantly, almost reaching control levels after 180 days.

Sarcolemmal integrity during ischaemia and reperfusion of the isolated rat heart

The effects of ischaemia and reperfusion on sarcolemmal permeability were studied in the isolated rat heart using an ionic lanthanum probe technique. Detection of increased permeability after exposure to short periods of ischaemia without accompanying reperfusion effects was achieved by employing a substrate-free, low calcium saline solution as vehicle for ionic lanthanum. Quantifiable results showed a rapid increase in sarcolemmal permeability in the subendocardium after 15 min of ischaemia, with the subepicardium showing similar alterations after longer periods. Reperfusion after 15 min of ischaemia led to recovery of normal permeability characteristics, correlating well with ultrastructural and functional recovery. Reperfusion after 25 min of ischaemia did not allow recovery of sarcolemmal permeability, ultrastructure, or function. These results show a clear correlation between the development of irreversible myocardial damage and increased sarcolemmal membrane permeability.

Phosphatidylcholine biosynthesis in myocardial ischaemia

In this study the effect of myocardial ischaemia was evaluated on two aspects of phospholipid metabolism: (i) the de novo synthesis of myocardial phospholipids, as indicated by the incorporation of (methyl-3H) choline and (ii) the incorporation of radiolabelled long chain fatty acids into tissue phospholipids. Two models of ischaemia were used namely normothermic ischaemic arrest and hypoxic, low-flow perfusion of the isolated rat heart. The results showed that within 10 min, hypoxic low-flow perfusion significantly inhibited the incorporation rate of (methyl-3H) choline into tissue phospholipids. Since the tissue choline content remained unaltered under these conditions, the results suggested that the de novo synthesis of phosphatidylcholine is very susceptible to ischaemic damage. Inhibition of (methyl-3H) choline incorporation into tissue phospholipids appeared to be due to both a reduction in choline uptake and specific inhibition of the CDP pathway. Perfusion with glucose (10 mM) as substrate completely abolished the ischaemia-induced reduction in (methyl-3H) choline incorporation, indicating that glycolytically produced ATP played an important role in phosphatidylcholine biosynthesis. In contrast to these results, myocardial ischaemia stimulated the incorporation of long-chain saturated and unsaturated fatty acids into tissue phospholipids. In summary, the results obtained showed that myocardial ischaemia profoundly affected phospholipid metabolism which, in turn, might contribute to membrane damage.

Sarcolemmal phospholipid fatty acid composition and permeability

In this study, the mechanism of ischaemia-induced increased sarcolemmal permeability, as manifested by release of intracellular enzymes, was investigated. The role of changes in the sarcolemmal phospholipid bilayer in this process was evaluated by experimental modulation of the phospholipid fatty acid composition. The isolated perfused rat heart subjected to low-flow hypoxia, was used as a model of global ischaemia. Glucose as well as saturated (palmitate) and unsaturated (linoleate) long-chain fatty acids were used as substrates. Hearts perfused with palmitate or linoleate (1.5 mM, fatty acid/albumin ratio, 3.4) showed a significantly higher rate of lactate dehydrogenase release in both control and ischaemic conditions than hearts perfused with glucose (10 mM). Lactate dehydrogenase release in the fatty acid-perfused hearts was associated with a significant increase in the percentage unsaturation of the sarcolemmal phospholipid fatty acids. Glucose-perfused hearts, on the other hand, showed only minor changes in the sarcolemmal phospholipid fatty acid composition. Attempts to correlate enzyme release directly with an increase in the percentage unsaturation of phospholipid fatty acids failed, since enzyme release was also stimulated in control fatty-acid-perfused hearts which (when compared with glucose) contained a higher percentage saturated phospholipid fatty acids. The results suggest that myocardial ischaemia, apart from changes in the sarcolemmal phospholipid fatty acid composition, also induces several other changes in sarcolemmal composition (e.g., cholesterol loss) which may affect is permeability for macromolecules.

Oxygen requirements of the isolated rat heart during hypothermic cardioplegia. Effect of oxygenation on metabolic and functional recovery after five hours of arrest

Previous studies from this laboratory demonstrated that the use of an oxygenated cardioplegic solution in the hypothermic arrested rat heart resulted in improved preservation of high-energy phosphate stores (adenosine triphosphate and creatine phosphate), mechanical recovery during reperfusion, and preservation of myocardial ultrastructure. In the current study the effect of cardioplegic solutions oxygenated with 30%, 60%, and 95% oxygen was evaluated in the isolated rat heart with reference to the maintenance of adenosine triphosphate, creatine phosphate, oxygen consumption, functional recovery, and mitochondrial oxidative phosphorylation in vitro. Results indicate that the hearts receiving cardioplegic solutions supplemented with 95% oxygen and 5% carbon dioxide maintained adenosine triphosphate and creatine phosphate at control values for at least 5 hours. The oxygen consumption during elective cardiac arrest, mechanical performance during reperfusion, and in vitro mitochondrial oxygen uptake and phosphorylation rate were highest in the hearts receiving cardioplegic solutions supplemented with 95% oxygen when compared to solutions with 30% and 60% oxygen. Addition of glucose and insulin to the cardioplegic solution (95% oxygen) increased the adenosine triphosphate levels but failed to improve function after reperfusion. Although myocardial adenosine triphosphate and creatine phosphate were well preserved by the oxygenated cardioplegic solution, there was a discrepancy between the adenosine triphosphate levels at the end of the arrest period, which represents the potential for mechanical function, and the actual function of the hearts after 5 hours.

Enzymatic and structural modifications of mitochondrial NADH-ubiquinone reductase with autolysis as experimental model

Complex I (nicotinamide adenine dinucleotide-ubiquinone reductase) is a complex enzyme system located in the inner mitochondrial membrane. It has the ability to catalyze several different enzymatic reactions in electron transport, and is known to be one of the respiratory chain components most sensitive to ischaemia. Mitochondria and two complexes I (complex IA and complex IB) were isolated from normal and ischaemic myocardial tissue. Enzymatic activities, polypeptide composition, as well as other components such as non-haem iron, acid-labile sulphur and ubiquinone, were determined. The results indicated that complex IB reflected the enzymatic changes in the mitochondria during myocardial ischaemia, but complex IA did not. The lesion that resulted from ischaemia was localised as altered enzymatic activities due to a different polypeptide composition, as well as loss of ubiquinone and non-haem iron from complex IB.

Inhibition of contractility during the early phase of total ischaemia in the working heart. Recovery during reperfusion

Total global ischaemia of the normothermic working rat heart caused an initial positive inotropic response characterized by vigorous contractions. After +/- 15 s this response reached a peak whereafter the isotonic contraction amplitude started to decline. After +/- 3.5 min the heart ceased to beat. The low level of high energy phosphates (HEP), determined 3 min after the onset of ischaemia, indicated that these phases of contractility during ischaemia might play a significant role in depleting HEP. This was substantiated by the observation that inhibition of the contractions during ischaemia by low calcium or high potassium solutions resulted in conservation of myocardial adenosine triphosphate (ATP) and creatine phosphate (CP) stores. It also resulted in the prevention of contracture development during ischaemia and improved mechanical recovery during reperfusion. It was therefore concluded that inhibition of contractility immediately after the onset of total global ischaemia of the normothermic working rat heart is of prime importance in mechanical recovery during reperfusion.

Mitochondrial Ca2+ fluxes and levels during ischaemia and reperfusion: possible mechanisms

It has been shown that myocardial ischaemia depresses the uptake and enhances the release of Ca2+ by mitochondria. Reperfusion of the ischaemic areas may result in a further deterioration of the above processes. Despite these marked changes in Ca2+ fluxes, reperfusion has been shown always to be associated with a marked increase in mitochondrial Ca2+ content. To explain the latter observation, it has been proposed that reperfusion promotes respiration-supported mitochondrial Ca2+ uptake in preference to ADP phosphorylation. To evaluate this hypothesis, the effect of exogenous ADP on mitochondrial respiration-linked Ca2+ uptake was investigated in control, ischaemic and ischaemic-reperfused hearts. The results show that ADP significantly depresses mitochondrial Ca2+ uptake in all three preparations, indicating that Ca2+ is not taken up preferentially to ADP phosphorylation in reperfused tissue. It is suggested that reperfusion-induced increased mitochondrial Ca2+ levels are probably not due to increased respiration-linked Ca2+ uptake, but rather to augmented conversion of ionized Ca2+ to calcium phosphate which does not participate in ionic fluxes.

Ultrastructural observations on the effects of different substrates on ischaemic contracture in global subtotal ischaemia in the rat heart

Ultrastructural morphology was examined in myocardia perfused with different substrates, following the hypothesis that ultrastructural changes or differences would indicate the mechanism of early ischaemic contracture. Substrates used were glucose, acetate and no substrate (substrate-free). Isolated rat hearts were subjected to global low flow ischaemia followed by perfusion fixation at either no contracture, early contracture (5%) or full contracture (100%). Total tissue adenosine triphosphate (ATP) levels were analysed from myocardia of each group. Glucose perfused myocardia did not develop contracture for at least 30 minutes and maintained ultrastructural and ATP normality. Substrate-free and acetate perfused myocardia developed contracture after 10-12 minutes of ischaemia at which time myofibrillar morphology was altered within small sparse foci of developing mild oedema with contracture and hyperextension of myofibrils. ATP levels were normal. At full ischaemic contracture, both substrate-free and acetate perfused myocardia showed severe mitochondrial damage, oedema, myofibrillar contracture and hyperextension with accompanying distortion and swelling of the sarcoplasmic reticulum.

Gas chromatographic-mass spectrometric analysis of volatile constituents in saliva

Present methods for the development of metabolic profiles are limited to the use of headspace techniques and solvent extraction methods. A new method for the development of saliva profiles which provides information complementary to existing analyses has been developed. The results of the developed methodology provide a reliable, reproducible method for metabolic profiling. Gas chromatographic-mass spectrometric analysis of the volatile constituents provided positive identification of 39 compounds. Application of the developed protocol toward the investigation of saliva as a vehicle for the non-invasive detection of certain pathological states, specifically diabetes mellitus and liver disorders, may be possible.

Mitochondrial Ca2+ fluxes: role of free fatty acids, acyl-CoA and acylcarnitine

It has been suggested that accumulation of lipid metabolites, such as fatty acids, fatty acyl-CoA and acylcarnitine, in the ischaemic myocardium, may be responsible for disturbances in mitochondrial Ca2+ fluxes. In view of the presence of an intracellular fatty acid binding protein, the question arose whether these intermediates affect mitochondrial Ca2+ uptake and release similarly in vivo. In this study the effects of linoleic acid, palmitic acid, palmitoyl-CoA and palmitoylcarnitine were studied on mitochondrial Ca2+ fluxes in the absence and presence of albumin, an avid binder of fatty acid derivatives. Albumin reversed the effects of the above compounds on mitochondrial Ca2+ uptake and release, suggesting that the presence of an intracellular fatty acid binding protein may protect the ischaemic myocardial cell against the deleterious effects of accumulated fatty acid derivatives.

Isolation of a physiologically active and a physiologically inactive mitochondrial NADH-ubiquinone reductase (complex I) from donkey hearts

The method described for the isolation of mitochondrial complex I (NADH-ubiquinone reductase) from bovine hearts could not be applied to donkey hearts as unacceptably large losses in enzyme activity occurred. This method was modified for the isolation of complex I using donkey hearts and two complexes were obtained: complex IA which was physiologically inactive and complex IB which was physiologically active as it catalyzed the reaction from NADH to ubiquinone. Both complexes had relatively low enzyme activity with artificial electron acceptors, except with potassium ferricyanide, and had more or less the same amount of acid-labile sulfur and nonheme iron although the polypeptide composition differed to a great extent.