Nobumasa Ishide

Effects of long-term pressure overload on regional myocardial glucose and free fatty acid uptake in rats. A quantitative autoradiographic study.

To investigate the effects of long-term pressure overload on regional myocardial substrate use, we performed quantitative autoradiography using 2-deoxy-D-[U-14C]glucose (14C-DG) and beta-methyl[1-14C]heptadecanoic acid (14C-BMHDA) in conscious rats with a 10-week ascending aortic constriction. Heart weight/body weight ratio increased by 27% in aortic-constricted rats as compared with sham-operated rats (p less than 0.01). Myocardial 14C-DG uptake increased (258 +/- 63 vs. 144 +/- 41 nCi/g, p less than 0.01, n = 6 for each group); however, 14C-BMHDA extraction decreased (251 +/- 69 vs. 342 +/- 75 nCi/g, p less than 0.05, n = 7 for each group) in aortic-constricted rats as compared with sham-operated rats. In sham-operated rats, both 14C-DG and 14C-BMHDA uptakes were higher in the left ventricular anterior and lateral walls as compared with the posterior wall or the interventricular septum. In aortic-constricted rats, 14C-DG uptake also increased in the interventricular septum, as well as in the left ventricular anterior and lateral walls, as compared with the posterior wall. There was, however, no regional difference in 14C-BMHDA extraction among these four regions. Myocardial blood flow distribution determined by 4-[N-methyl-14C]iodoantipyrine or myocyte width showed no regional variations among the four regions, either in aortic-constricted or sham-operated rats. Regional interstitial fibrosis was small in either group. The present study suggests that myocardial substrate uptake is altered nonhomogeneously, and that the nonhomogeneity is not because of regional variations in blood flow distribution, myocyte hypertrophy, or interstitial fibrosis. The results of angiotensin II-induced acute pressure overloading in other sham-operated rats, in which a remarkable increase in myocardial 14C-BMHDA extraction (n = 3, p less than 0.01) and no difference in 14C-DG uptake (n = 3) as compared with normotensive sham-operated rats were elicited, suggest that the findings in aortic-constricted rats are not direct responses to increased left ventricular pressure itself but rather should be explained by still unknown factors related to prolonged pressure overload.

Effects of chronic right ventricular pressure overload on myocardial glucose and free fatty acid metabolism in the conscious rat

OBJECTIVE The aim was to investigate the effects of chronic right ventricular pressure overload on myocardial glucose and free fatty acid metabolism in the right ventricular free wall, ventricular septum, and left ventricular free wall. METHODS Using a glucose analogue, 14C-2-deoxyglucose (14C-DG), and a fatty acid analogue, 14C-beta methylheptadecanoic acid (14C-BMHDA), quantitative autoradiography was performed in conscious rats with 4 week pulmonary artery constriction. RESULTS In rats with chronic pulmonary artery constriction, right ventricular peak systolic pressure and right ventricular weight to body weight ratio increased by 88% and 127%, respectively, compared with sham operated rats (P < 0.01 for each). In the right ventricular free wall, 14C-DG deposition increased but 14C-BMHDA accumulation did not differ in the chronic pulmonary artery constricted rats compared with sham operated rats [212(SEM 27), n = 6 v 101(15) nCi.g-1, n = 4, P < 0.01, and 406(40), n = 6, v 333(48) nCi.g-1, n = 4, NS, respectively]. In sham operated rats, 14C-DG and 14C-BMHDA deposition did not differ between the ventricular septum and the left ventricular free wall. In contrast, 14C-DG and 14C-BMHDA accumulations were lower in the ventricular septum compared with the left ventricular free wall wall in chronic pulmonary artery constricted rats. Myocardial blood flow assessed by 14C-iodoantipyrine was homogeneously distributed throughout both ventricles. CONCLUSIONS Chronic right ventricular pressure overload increases myocardial glucose uptake and/or its phosphorylation in the right ventricular free wall, and alters the regional profiles of substrate use in the ventricular septum and left ventricular free wall despite the homogeneous blood flow distribution. The results of the acute right ventricular pressure overload study, in which only right ventricular 14C-BMHDA deposition was increased compared with controls, suggest that the findings obtained from chronic pulmonary artery constricted rats cannot be explained by increased right ventricular pressure alone.

Experimental study of afterload-reducing therapy: the effects of the reduction of systemic vascular resistance on cardiac output, aortic pressure and coronary circulation in isolated, ejecting canine hearts.

The relationship between cardiac output (CO) and peripheral resistance (Rp) was examined under the following conditions for coronary perfusion: constant coronary flow perfusion; perfusion with a pressure equal to mean aortic pressure (AoP perfusion); and perfusion with a pressure equal to the mean AoP - 30 mm Hg (AoP - 30 mm Hg perfusion). We also examined the coronary pressure-flow relationship. For these studies, we used paced, isolated, ejecting canine hearts, which were loaded by a hydraulic system that simulated the input impedance of a dogs systemic arterial tree.The CO in the constant coronary flow perfusion continued to increase with the reduction of Rp. The CO in the AoP perfusion became maximal at a slightly subphysiologic Rp, or at an average mean AoP of 65 mm Hg. This mean AoP was closely associated with the lower limit of the autoregulation of coronary blood flow. In the AoP - 30 mm Hg perfusion, the mean AoP at which CO became maximal was 72 mm Hg and the corresponding coronary perfusion pressure appeared to be lower than the lower limit of the perfusion pressure range for coronary flow autoregulation. The Rp value at that point was slightly higher than the physiologic range.We conclude that when coronary perfusion pressure changes with mean AoP, and when left ventricular enddiastolic pressure is fixed, there is a clear optimal Rp at which CO becomes maximal, and this optimal Rp is higher if coronary perfusion pressure is biased from mean AoP to a significant degree.

Interaction between sarcomere and mitochondrial length in normoxic and hypoxic rat ventricular papillary muscles

We hypothesized that the mitochondrial length may be altered according to changes in the sarcomere length, and that this relationship may be affected by exposure to hypoxia. Rat ventricular papillary muscles were isolated and immersed in normoxic or hypoxic solutions for 10 min. Sarcomeres of various lengths were obtained by fixing the papillary muscles in a slack or stretched state, or after exposure to a contracture solution containing saponin and CaCl(2). The mitochondrial length measured using electron microscopy significantly correlated to the length of the adjacent sarcomere in both the normoxic (n=767) and hypoxic (n=1145) groups (P<.0001). The slope of the regression line, however, was significantly less steep, and its intercept was significantly larger in the hypoxic group than in the normoxic group (analysis of covariance). When we analyzed the mitochondrial lengths among the three sarcomere-length subgroups (<1.5, 1.5-2.0, and >2.0 microm), the mitochondrial length was significantly shorter in the hypoxic condition than in the normoxic condition at sarcomere lengths greater than 2.0 microm. Staining for desmin, the major muscle-type intermediate filament, the longitudinal system of which connects the mitochondria with the Z bands of sarcomeres, showed a clear cross-striation pattern in both papillary muscles with and without the exposure to hypoxia, suggesting that desmin was preserved after the exposure to hypoxia. These data indicate that the mitochondrial length changes according to changes in the sarcomere length, suggesting the possible role of mitochondria as an internal load against myocyte contraction. It is also suggested that mitochondria exposed to hypoxia may be more resistive to both compression and stretch in a longitudinal direction than those in the normoxic condition.

Long-Term Right Ventricular Volume Overload Increases Myocardial Fluorodeoxyglucose Uptake in the Interventricular Septum in Patients With Atrial Septal Defect

BACKGROUND Several studies have shown that long-term right ventricular (RV) overload in animal models alters myocardial energy substrate metabolism. However, whether long-term RV volume overload alters this metabolism in the human is unclear. METHODS AND RESULTS We performed positron emission tomography with [(18)F]fluorodeoxyglucose (FDG) and single-photon emission tomography (SPECT) with [(201)Tl]TlCl (Tl) and [(123)I]15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) in 11 patients with atrial septal defect (ASD) and 11 control subjects. In the FDG study, we calculated myocardial metabolic rate of glucose (MMR) in interventricular septum (IVS) and left ventricular (LV) free wall. MMR was significantly increased in IVS compared with LV free wall in the ASD patients (420+/-35 versus 333+/-32 mol x kg(-1) x min(-1); P<0.05) but not in the control group (347+/-27 versus 357+/-25 mol x kg(-1) x min(-1)). In both ASD and control groups, SPECT count was not significantly different between IVS and LV free wall in Tl (ASD, 160+/-11 versus 177+/-12; control, 141+/-12 versus 157+/-14 counts per 15 minutes) and BMIPP studies (ASD, 203+/-14 versus 212+/-18; control, 162+/-16 versus 176+/-16 counts per 15 minutes). MMR in the IVS/LV free wall ratio in the ASD group significantly correlated with indices related to RV volume overload. CONCLUSIONS Given the assumption that long-term RV volume overload did not affect the lumped constant, the present study suggests that, unlike myocardial perfusion or fatty acid analogue uptake, myocardial glucose utilization in IVS relative to LV free wall is increased in relation to long-term RV volume overload in patients with ASD.

Differences in myocardial fluoro-18 2-deoxyglucose uptake in young versus older patients with hypertrophic cardiomyopathy

The purpose of this study was to determine whether regional myocardial glucose use in patients diagnosed as having hypertrophic cardiomyopathy (HC) at a younger age differs from that in those diagnosed at middle to old age. Sixteen patients with HC (group 1 aged less than 40 years (n = 8); group 2 aged greater than 40 (n = 8) were studied using positron emission tomography and fluoro-18 2-deoxyglucose (FDG). All patients were diagnosed as having HC within 6 years of the study. Contiguous regions of interest were selected circumferentially on each cross-sectional image of the left ventricular wall. In each region of interest, % FDG fractional uptake was calculated. In each patient, % left ventricular FDG fractional uptake was determined as a mean value of % FDG fractional uptake in each region of interest. Moreover, as a measure of nonhomogeneity, the % interregional coefficient of variation in FDG fractional uptake was calculated in each patient. Whereas % left ventricular FDG fractional uptake did not differ between the 2 groups, the % interregional coefficient of variation in FDG fractional uptake was increased in group 1 compared with that in group 2 (11.5 +/- 3.6 vs 7.4 +/- 1.6%; p less than 0.02). Interventricular septum/left ventricular posterior wall thickness ratio and total counts in cross-sectional image did not differ between the 2 groups. These data suggest that patients diagnosed as having HC at a younger age have more nonhomogeneous myocardial metabolic characteristics than do patients diagnosed at middle or old age, and support the notion that HC in the young may be different from that in the middle-aged or elderly.

The effect of graded coronary flow reduction in the left anterior descending and septal arteries on left ventricular function in the canine heart.

We quantitatively analyzed the effect of graded left anterior descending and septal coronary flow (LAD + septal flow) reduction on left ventricular function with a left ventricular end-diastolic pressure (LVEDP) of 6 mm Hg and 12 mm Hg. We used an isolated, ejecting, canine heart preparation (n = 8), the coronary flow of which could be controlled independently of the aortic pressure. We kept the other hemodynamic variables — heart rate, left circumflex coronary flow, right coronary flow and aortic input impedance — constant within their normal physiologic range. We considered this reduction in LAD + septal flow to be analogous to that of the most frequent lesion in ischemic heart disease. There was no plateau in the left ventricular work caused by this reduction of the regional coronary flow. Therefore, the plateau commonly reported in previous studies may be partially a result of the compensatory elevation of LVEDP, which is necessary to maintain the left ventricular work.

Diversity of early afterdepolarizations in guinea pig myocytes: Spatial characteristics of intracellular Ca2+ concentration

SummaryWe classified early afterdepolarizations (EADs) into subgroups according to the spatial features of the intracellular Ca2+ concentration ([Ca2+]i). Myocytes were enzymatically isolated from guinea pig ventricles. When fura-2 salt was applied through a whole cell patch pipette after the formation of a gigaohm seal, the membrane potential was measured using the current, clamp technique. When myocytes were loaded with fura-2 AM, the membrane potential was recorded with a conventional microelectrode technique. Spatio-temporal changes in fura-2 fluorescence and cell length were recorded simultaneously, using a digital TV system. EADs were induced after superfusion with potassium-free Tyrode solution. Irrespective of the fura-2 loading procedure, EADs could be classified into those with spatially synchronous fluorescence changes (n = 26 from eight hearts) and those with heterogeneous changes (n = 20 from three hearts). EADs with synchronous features took off from a higher membrane potential (≥−34mV) than EADs with heterogeneous features (≤−57 mV). These results suggest that EADs have at least two constituents.

Interactions between calcium waves and action potential-induced calcium transients in guinea pig myocytes

SummaryIn isolated cardiac muscle, spontaneous Ca2+ release from the sarcoplasmic reticulum (SR) occurs and is propagated as a wave by a regenerative Ca2+-induced Ca2+ release mechanism. We have already reported that this wave is followed by a refractory period. The aim of this study is to investigate whether such a refractory period could also inactivate Ca2+ release from the SR triggered by an action potential. Myocytes were enzymatically isolated from guinea pig ventricles and loaded with acetoxymethylester form of fura-2 (fura-2 AM). The membrane potential was recorded with a conventional microelectrode technique, and spatio-temporal changes in fura-2 fluorescence were recorded using a digital TV system. After perfusion with potassium-free Tyrode solution, interactions between fluorescence transients due to propagating waves and action potential-induced fluorescence transients were observed. In this study, the action potentialinduced fluorescence transients could be detected in the next video frame after the propagation of the waves and showed gradual restitution of the transients. In addition, the sum of the fluorescence transients triggered by an action potential and the fluorescence transients due to the waves did not show significant change whenever the preceding waves were propagating. These results show that the interaction between the action potential-induced Ca2+ release and the calcium wave-induced Ca2+ release from the SR have the following characteristics: (1) For the action potentialinduced Ca2+ release, no absolute refractory period was observed 33 msec after the calcium wave. This suggests that the calcium waves can be reset by the action potential. (2) Regardless of whether the two release mechanisms are different, both share a common compartment of Ca2+ storage.

Heterogeneous fatty acid uptake early after reperfusion in rat hearts

We determined whether spatial distributions of substrate uptake are heterogeneous within the area at risk during reperfusion. Quantitative autoradiography with imaging plates and two long-lived radioisotopes was applied to 15 open-chest, anesthetized rats subjected to 30 min of coronary artery ligation and 30 min of reperfusion. Regions showing increased beta-methyl-[1-14C]heptadecanoic acid ([14C]BMHDA) uptake (166 +/- 17% of that in the nonischemic area) appeared at the lateral borders and subepicardial layer within the area at risk, and 2-deoxy-D-[1-3H]glucose ([3H]DG) uptake was 103 +/- 24% in these regions. Regions with decreased [14C]BMHDA uptake (28 +/- 11%) occupied the midmyocardial layer except at the lateral borders within the area at risk, and [3H]DG uptake was 62 +/- 18% in these regions. The percentage interregional coefficients of variation (index of heterogeneity) in [14C]BMHDA uptake, [3H]DG uptake, and blood flow were higher in the area at risk than in the nonischemic area (76 +/- 23 vs. 21 +/- 7%, 39 +/- 10 vs. 21 +/- 7%, and 49 +/- 19 vs. 14 +/- 4%, respectively). Heterogeneous distributions of substrate uptake may explain the conflicting results concerning substrate metabolism during reperfusion.We determined whether spatial distributions of substrate uptake are heterogeneous within the area at risk during reperfusion. Quantitative autoradiography with imaging plates and two long-lived radioisotopes was applied to 15 open-chest, anesthetized rats subjected to 30 min of coronary artery ligation and 30 min of reperfusion. Regions showing increased β-methyl-[1-14C]heptadecanoic acid ([14C]BMHDA) uptake (166 ± 17% of that in the nonischemic area) appeared at the lateral borders and subepicardial layer within the area at risk, and 2-deoxy-d-[1-3H]glucose ([3H]DG) uptake was 103 ± 24% in these regions. Regions with decreased [14C]BMHDA uptake (28 ± 11%) occupied the midmyocardial layer except at the lateral borders within the area at risk, and [3H]DG uptake was 62 ± 18% in these regions. The percentage interregional coefficientsof variation (index of heterogeneity) in [14C]BMHDA uptake, [3H]DG uptake, and blood flow were higher in the area at risk than in the nonischemic area (76 ± 23 vs. 21 ± 7%, 39 ± 10 vs. 21 ± 7%, and 49 ± 19 vs. 14 ± 4%, respectively). Heterogeneous distributions of substrate uptake may explain the conflicting results concerning substrate metabolism during reperfusion.