Modification of the physiological determinants of cardiac energy expenditure by pharmacological agents

Tight coupling of Na+/K+-ATPase with glycolysis demonstrated in permeabilized rat cardiomyocytes

The effective integrated organization of processes in cardiac cells is achieved, in part, by the functional compartmentation of energy transfer processes. Earlier, using permeabilized cardiomyocytes, we demonstrated the existence of tight coupling between some of cardiomyocyte ATPases and glycolysis in rat. In this work, we studied contribution of two membrane ATPases and whether they are coupled to glycolysis--sarcoplasmic reticulum Ca2+ ATPase (SERCA) and plasmalemma Na+/K+-ATPase (NKA). While SERCA activity was minor in this preparation in the absence of calcium, major role of NKA was revealed accounting to ∼30% of the total ATPase activity which demonstrates that permeabilized cell preparation can be used to study this pump. To elucidate the contribution of NKA in the pool of ATPases, a series of kinetic measurements was performed in cells where NKA had been inhibited by 2 mM ouabain. In these cells, we recorded: ADP- and ATP-kinetics of respiration, competition for ADP between mitochondria and pyruvate kinase (PK), ADP-kinetics of endogenous PK, and ATP-kinetics of total ATPases. The experimental data was analyzed using a series of mathematical models with varying compartmentation levels. The results show that NKA is tightly coupled to glycolysis with undetectable flux of ATP between mitochondria and NKA. Such tight coupling of NKA to PK is in line with its increased importance in the pathological states of the heart when the substrate preference shifts to glucose.

Left Ventricular Mechanoenergetics in Small Animals

Studies on left ventricular mechanical work and energetics in rat and mouse hearts are reviewed. First, left ventricular linear end-systolic pressure-volume relation (ESPVR) and curved end-diastolic pressure-volume relation (EDPVR) in canine hearts and left ventricular curved ESPVR and curved EDPVR in rat hearts are reviewed. Second, as an index for total mechanical energy per beat in rat hearts as in canine hearts, a systolic pressure-volume area (PVA) is proposed. By the use of our original system for measuring continuous oxygen consumption for rat left ventricular mechanical work, the linear left ventricular myocardial oxygen consumption per beat (VO2)-PVA relation is obtained as in canine hearts. The slope of VO2-PVA relation (oxygen cost of PVA) indicates a ratio of chemomechanical energy transduction. VO2 intercept (PVA-independent VO2) indicates the summation of oxygen consumption for Ca2+ handling in excitation-contraction coupling and for basal metabolism. An equivalent maximal elastance (eEmax) is proposed as a new left ventricular contractility index based on PVA at the midrange left ventricular volume. The slope of the linear relation between PVA-independent VO2 and eEmax (oxygen cost of eEmax) indicates changes in oxygen consumption for Ca2+ handling in excitation-contraction coupling per unit changes in left ventricular contractility. The key framework of VO2-PVA-eEmax can give us a better understanding for the biology and mechanisms of physiological and various failing rat heart models in terms of mechanical work and energetics.

Halothane, isoflurane and sevoflurane inhibit NADH:ubiquinone oxidoreductase (complex I) of cardiac mitochondria

We have investigated the effects of volatile anaesthetics on electron transport chain activity in the mammalian heart. Halothane, isoflurane and sevoflurane reversibly increased NADH fluorescence (autofluorescence) in intact ventricular myocytes of guinea-pig, suggesting that NADH oxidation was impaired. Using pig heart submitochondrial particles we found that the anaesthetics dose-dependently inhibited NADH oxidation in the order: halothane > isoflurane = sevoflurane. Succinate oxidation was unaffected by either isoflurane or sevoflurane, indicating that these agents selectively inhibit complex I (NADH:ubiquinone oxidoreductase). In addition to inhibiting NADH oxidation, halothane also inhibited succinate oxidation (and succinate dehydrogenase), albeit to a lesser extent. To test the hypothesis that complex I is a target of volatile anaesthetics, we examined the effects of these agents on NADH:ubiquinone oxidoreductase (EC 1.6.99.3) activity using the ubiquinone analogue DBQ (decylubiquinone) as substrate. Halothane, isoflurane and sevoflurane dose-dependently inhibited NADH:DBQ oxidoreductase activity. Unlike the classical inhibitor rotenone, none of the anaesthetics completely inhibited enzyme activity at high concentration, suggesting that these agents bind weakly to the 'hydrophobic inhibitory site' of complex I. In conclusion, halothane, isoflurane and sevoflurane inhibit complex I (NADH:ubiquinone oxidoreductase) of the electron transport chain. At concentrations of approximately 2 MAC (minimal alveolar concentration), the activity of NADH:ubiquinone oxidoreductase was reduced by about 20 % in the presence of halothane or isoflurane, and by about 10 % in the presence of sevoflurane. These inhibitory effects are unlikely to compromise cardiac performance at usual clinical concentrations, but may contribute to the mechanism by which volatile anaesthetics induce pharmacological preconditioning.

Exaggerated chronotropic and energetic response to dobutamine after orthotopic cardiac transplantation

BACKGROUND

After heart transplantation, the transplanted denervated heart displays both an exaggerated chronotropic and an exaggerated inotropic response to circulating catecholamines. This study assessed whether denervated transplanted hearts also display an exaggerated energetic response when challenged with dobutamine.

METHODS AND RESULTS

A total of 18 heart transplant recipients and 14 normal volunteers underwent measurements of myocardial oxygen consumption (MVO2), external work (EW), and pressure-volume area (PVA), at rest and during infusion of dobutamine. At rest, calculated myocardial (PVA/MVO2) and mechanical (EW/MVO2) efficiencies were similar among transplant recipients and normal volunteers. During low-dose dobutamine infusion (8 microg/kg/min), transplant recipients exhibited a larger increase in heart rate (to 126 +/- 14 vs 87 +/- 26 beats/min, p < 0.001) and MVO2 (to 269 +/- 43 vs 233 +/- 19 J/min/100g, p < 0.05) and a smaller increase in EW (64 +/- 18 vs 72 +/- 13 J/min/100g, p < 0.05) and PVA (70 +/- 16 vs 81 +/- 13 J/min/100g, p < 0.05) than did normal volunteers. As a result, both myocardial (26 +/- 4 vs 35 +/- 4%, p < 0.05) and mechanical (23 +/- 4 vs 30 +/- 4%, p < 0.001) efficiencies were lower during dobutamine infusion in transplant recipients than in normal volunteers. During the infusion of a higher dose of dobutamine (19 microg/kg/min), the chronotropic and inotropic responses of heart transplant recipients were even more exaggerated. The fall in myocardial efficiency induced by dobutamine correlated with the increase in heart rate (r = -0.58) and could be reproduced in normal volunteers by coadministration of atropine.

CONCLUSIONS

Transplant recipients exhibit a larger fall in contractile efficiency and a larger oxygen-wasting effect during dobutamine infusion than do normal volunteers. Because normal volunteers pre-medicated with atropine presented with a similar increase in heart rate and a similar fall in efficiency, the exaggerated energetic response of transplanted hearts to dobutamine likely resulted from the same mechanisms as their chronotropic supersensitivity, i.e., the loss of inhibitory parasympathetic innervation.

Effect of exercise on left ventricular mechanical efficiency in conscious dogs

BACKGROUND

We studied the effect of exercise (7.2 to 8.0 km/h) on the efficiency of the conversion of metabolic energy to external work or stroke work (SW) by the left ventricle (LV).

METHODS AND RESULTS

Energy use was calculated from LV myocardial oxygen consumption per beat (MVO2). LV volume was calculated from orthogonal dimensions and coronary flow measured with ultrasonic flow probes. The total mechanical energy of the LV was calculated as the pressure-volume area (PVA). At rest, the MVO2-PVA point fell on the MVO2-PVA relation determined by steady-state changes in arterial pressure produced by graded infusions of phenylephrine. Exercise increased the slope (Ees) of LV end-systolic pressure-volume (PV) relation by 29%. During exercise, the MVO2-PVA point shifted to the right only slightly above the control MVO2-PVA relation by 0.007 +/- 0.005 mL O2.beat-1.100 g LV-1. Despite the increase in ventricular contractility with exercise, the PVA/MVO2 ratio was unchanged because of the marked increase in PVA. During exercise, the transmission of total mechanical energy to external work (SW/PVA) increased from 65 +/- 5% to 72 +/- 4% (P < .01) as the ratio of the arterial end-systolic elastance to Ees decreased from 1.1 +/- 0.2 to 0.8 +/- 0.1 (P < .05). Thus, LV mechanical efficiency (SW/MVO2 = SW/PVA.PVA/MVO2) improved from 12.9 +/- 1.5% to 14.3 +/- 1.1% (P < .05) during exercise.

CONCLUSIONS

Exercise increases the efficiency of conversion of metabolic energy to external work by the LV due to alteration in LV arterial coupling resulting in increased production of mechanical energy and enhanced transmission of mechanical energy to external work, which more than offsets any increased metabolic cost of the enhanced contractility.

Basal metabolism adds a significant offset to unloaded myocardial oxygen consumption per minute

Myocardial oxygen consumption (MVO2) includes components for 1) mechanical energy generation, 2) activation, and 3) basal metabolism. Whereas the first two components are expected to increase in proportion with heart rate, a significant basal level of metabolism would consume oxygen even if the heart rate were zero. Contrary to this expectation, however, a previous study reported that, during unloaded beats, MVO2 per beat (which includes basal metabolism) was independent of heart rate. Accordingly, unloaded MVO2 per minute would extrapolate to zero at zero heart rate; this result is unexpected considering basal metabolism. To resolve this inconsistency, we varied heart rate over a wide range after inducing atrioventricular block in eight isolated cross-circulated canine hearts that contracted isovolumically. We examined whether a term representing rate-independent basal metabolism was needed to describe MVO2 per minute. Mechanical energy generated by the left ventricle was evaluated from the pressure-volume area, which was altered by changing isovolumic ventricular volume over at least five levels at each heart rate. Contractility, evaluated by the slope of the end-systolic pressure-volume relation, did not vary significantly with heart rate in this study. In contrast to the previous report, unloaded MVO2 per beat (i.e., MVO2 extrapolated to a pressure-volume area of zero) was not constant but fell monotonically with increases in heart rate in every heart. We considered that this trend was caused by a significant rate-independent basal level of MVO2 per minute. Multiple linear regression analysis confirmed that this rate-independent basal term differed significantly from zero in seven of the eight hearts studied.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of 2,3-butanedione monoxime on initial heat, tension, and aequorin light output of ferret papillary muscles

At low concentrations (up to 5 mM) the compound 2,3-butanedione monoxime (BDM) was found to reduce twitch tension and initial heat production in isolated papillary muscles without significantly affecting the size of the intracellular Ca2+ transient measured with aequorin luminescence. Higher concentrations of BDM caused further inhibition of twitch tension and heat production with a fall in the size of the Ca2+ transient. The size of the aequorin transient was 50% of the control value at 15 mM BDM while twitch tension was negligible. These results suggest that BDM selectively inhibits Ca2+ activated force in cardiac muscle at low concentrations with additional effects on intra-cellular calcium at concentrations above 5 mM.

Efficiency of energy transfer from pressure-volume area to external mechanical work increases with contractile state and decreases with afterload in the left ventricle of the anesthetized closed-chest dog

We studied the effects of ventricular end-systolic elastance (Ees) and effective arterial elastance (Ea) on the efficiency of energy transfer from pressure-volume area (PVA) to external mechanical work (EW) in the left ventricle of anesthetized closed-chest dogs. PVA represents the total mechanical energy generated by ventricular contraction, which is an intermediate form of energy between oxygen consumption, the total energy input, and EW, the effective energy output. PVA and EW were determined from ventricular pressure and volume, which were continuously measured with a volumetric conductance catheter. Measurements of Ees were obtained by transiently increasing afterload by an inflation of a Fogarty catheter in the thoracic descending aorta. Ea was determined as the ratio of end-systolic pressure to stroke volume. The EW/PVA efficiency of a steady-state contraction increased from 55% to 64%, with a 58% increase in Ees after dobutamine. Ees, which was smaller than Ea before dobutamine, became nearly equal to Ea after dobutamine, maximizing EW for a given end-diastolic volume. EW/PVA efficiency decreased with an abrupt increase in afterload before and after dobutamine. The sensitivity of the decrease in the EW/PVA efficiency to an increase in end-systolic pressure was significantly less after than before dobutamine. We could account for all these changes in EW/PVA efficiency by the relative changes in Ees and Ea in the pressure-volume diagram.

Transducing chemical energy into mechanical function: a comparative view

The energetics of muscle contraction can be understood in terms of the major cellular ATPases. The twitch isometric transduction efficiency is relatively constant across muscle types and species. Although many of the factors that alter the shape of the enthalpy:load relation in isotonic twitch contractions have been identified our molecular understanding is unsatisfactory and more studies are needed of mammalian muscles working closer to 37 degrees C. The thermodynamic efficiency of CB activity seems quite high, probably in excess of 70%. During maintained (tetanic) force there can be greater than a 1000 fold difference in energy usage across muscle types and there are factors that can down regulate CB activity: these factors remain to be fully identified in both skeletal and smooth muscles. The very diversity of muscle types and the different biochemical solutions that have emerged to match energy supply and demand should lead to important insights into the contractile mechanism. The corollary however also applies, it may be dangerous to take results obtained in one muscle type under a particular set of conditions, and extrapolate those findings to muscles in general.

Activation heat in rabbit cardiac muscle

1. Activation heat was estimated myothermically in right ventricular papillary muscles of rabbits using several different methods. 2. Gradual pre-shortening of muscles to a length (lmin) where no active force development took place upon stimulation led to relatively low estimates of activation heat (1.59 +/- 0.26-2.06 +/- 0.57 mJ g-1 blotted wet weight, mean +/- S.E.M., n = 10). 3. Quick releases applied during the latency period, before force development, from lmax to various muscle lengths allowed a heat-stress relation to be established. The zero-stress intercept of this relation estimated the activation heat to be 3.27 +/- 0.40 mJ g-1; this was close to the experimentally measured value of 3.46 +/- 0.39 mJ g-1 (mean +/- S.E.M., n = 23) found by quick release from lmax to lmin. 4. The magnitude of the activation heat measured by the quick-release technique is dependent upon the extracellular Ca2+ concentration and there is good correlation between activation heat magnitude and peak developed stress. 5. In agreement with expectations based on the aequorin data of Allen & Kurihara (1982) a prolonged period of time spent at a short length is shown to depress the subsequently determined activation heat. 6. Hyperosmotic solutions (2.5 x normal) only abolished active stress development at low stimulus rates (0.2 Hz) and the activation heat measured at lmax under these conditions was 2.03 +/- 0.12 mJ g-1 (mean +/- S.E.M., n = 6). This value was significantly lower than the latency release estimate of activation heat in the same preparations (2.93 +/- 0.39 mJ g-1). 7. The latency release method of estimating activation heat results in activation heat values that account for approximately 30% of total active energy flux per contraction; a fraction comparable to that found in skeletal muscle. Calculations based on the data suggest that, under our experimental conditions, total Ca2+ release per beat lies between 50 and 100 nmol g-1 wet weight which would produce less than half-maximal myofibrillar ATPase activity when allowance is made for the passive Ca2+-buffering capacity of the myocardial cell.

Cardiac energetics and the Fenn effect

The energy output of a cardiac contraction can be divided into several phenomenologically measured components, although it must be emphasized that such subdivisions are often thermodynamically misleading. There is an activation term that relates to Ca++ release and retrieval, a work term and a stress or load-dependent heat term. The work and load-dependent energy terms presumably have their origin in the actin-activated myosin ATPase. It can be shown that the enthalpy: load relationship has a similar format across both mammalian and amphibian hearts: the scaling of both the energy and load axes is however altered by changes in contractility. The fact that enthalpy production is so clearly load-dependent indicates that there is a Fenn effect in cardiac muscle, although the discovery that energy output is greatest in an isometric contraction clearly contradicts one of the two central findings of Fenn's skeletal muscle investigations. Cardiac oxygen consumption per beat can be linearly correlated with ventricular systolic pressure--volume area (PVA) which is defined in terms of stroke work and potential energy components. If the basal and activation components are subtracted out cardiac muscle can be shown to operate at a constant PVA efficiency. The existing myothermic and polarographic data can be reconciled with the PVA concept.

The effects of acute and chronic inotropic interventions on tension independent heat of rabbit papillary muscle

We have used the myothermal method to noninvasively monitor the amount of calcium cycled during a single isometric twitch of rabbit papillary muscle. Experiments were designed to test the working hypothesis that changes in peak twitch tension caused by pharmacological agents or changing haemodynamic conditions are accompanied by parallel changes in the tension independent heat (TIH) signal associated with Ca2+ cycling. We isolated the TIH signal by eliminating the tension dependent component of initial heat with a hyperosmotic Krebs solution containing 2,3-butanedione monoxime. Contrary to the working hypothesis, positive or negative inotropic effects on twitch tension caused by pressure overload hypertrophy, thyrotoxic hypertrophy, isoproterenol, and UDCG115 were not accompanied by parallel changes in TIH. Alternative explanations for the relation between peak twitch tension and TIH are explored.

Study on myocardial contractility after cardiopulmonary bypass versus cardioplegic arrest in an air-ejecting in vivo heart model

Cardiac function was assessed in a working in vivo canine heart preparation. Minute work and myocardial oxygen consumption (MVo2) were measured after a two-hour period of hypothermic hyperkalemic crystalloid cardioplegic arrest in one group of dogs (Group 1, N = 6) and in another group of dogs on cardiopulmonary bypass (CPB) alone (Group 2, N = 6). Results indicate that at an afterload of 50 cm H2O, minute work was the same in all hearts but MVo2 was significantly higher in Group 1 hearts at all levels of preload. At higher afterloads, both minute work and MVo2 were significantly greater in Group 1 hearts over the range of preloads tested. Ventricular compliance was decreased in Group 1 over the range of preloads studied. These results suggest that hearts undergoing cardioplegic arrest had better left ventricular contractility than hearts undergoing CPB alone.

The rate of resting heat production of rat papillary muscle

The rate of resting heat production of quiescent rat left ventricular papillary muscles was measured myothermically. The effects of contractile activity, stretch, oxygen partial pressure, temperature, amino acids and time were examined. The rate of basal heat production was the same throughout the day whether or not muscles contracted isotonically under a small pre-load. Passive stretch increased the rate of resting heat production; the stretch-induced increment was highly variable from muscle to muscle. The resting heat rate per se was only moderately sensitive to oxygen partial pressure and temperature, and was insensitive to the presence of amino acids in the bathing medium. The stretch-induced increase in resting heat rate was independent of these three factors. The rate of resting heat production declined exponentially with time to reach a plateau about 4 h following cardiectomy.