Metabolism of the heart in health and disease. Part III

Transmural gradients of glycolytic enzyme activities in left ventricular myocardium. I. The normal state.

Twelve experiments were performed on healthy, anesthetized dogs on constant ventilation. Blood pressure, acid-base status, oxygen supply and lactate/pyruvate metabolism were monitored in the blood. The activities of nine glycolytic enzymes were assayed in left ventricular myocardium. A presumably irreversible state of hemorrhagic shock was produced by the reservoir technique and its metabolic sequels recorded in the blood. The analysis of coronary sinus blood did not reveal an oxygen deficit of the heart. The majority of the enzymes assayed showed higher activities following shock. Exceptions were pyruvate kinase, LDH and α-HB-DH. Activity differences between sampling sites appeared following shock especially in the inner layer of the left ventricle. The pattern of transmural activity gradients previously found in the normal state was disturbed. The findings are against an oxygen deficit as a cause of cardiac deterioration in shock, suggesting structural derangements possibly due to catecholamine effects or toxic substances of peripheral origin.

Transmural gradients of glycolytic enzyme activities in left ventricular myocardium. II. Prolonged hemmorrhagic hypotension.

Arterial hypoxaemia, serum activities of go-t, gp-t and ldh, and centrilobular liver cell necrosis in pulmonary insufficiency

The CSF lactate/pyruvate ratio in cerebral hypoxia

In 10 experiments on anesthetized dogs, the response of the lactate/pyruvate system in arterial blood to progressive arterial hypoxemia was studied. By means of the a–v concentration differences, the response of the heart was studied in all 10 experiments and that of the brain and the kidney in 7. The lactate/pyruvate ratio in arterial blood rose significantly from controls before total body oxygen consumption was presumably depressed. However, the heart contributed to arterial blood changes only with extreme degrees of arterial desaturation. The critical oxygen levels in coronary sinus blood were: 7.1±0.4% saturation, pO210.3±0.6 mm Hg and 1.69±0.11 vol-% oxygen content. The change of the lactate/pyruvate ratio across the heart and lactate output alone gave identical results in this respect. No response of the lactate/pyruvate system of the brain and of the kidney was observed in these experiments. The results demonstrate a nonuniform contribution of different organs to arterial blood changes during progressive arterial hypoxemia and favour the hypothesis of a predominant role of the liver and possibly skeletal muscle in the early arterial changes of lactate and pyruvate.

Regional differences of the lactate-pyruvate response to progressive arterial hypoxemia.

Wir pruften im experimentellen hamorrhagischen Schock an Hunden die Verteilung des im arteriellen Blut nachweisbaren Sauerstoffmangels auf das Einstromgebiet der V. cava inferior als reprasentativ fur die Kreislaufperipherie und auf das Herz. An Hand von Sauerstoff-, Lactat-und Pyruvatbestimmungen im Blut aus A. femoralis, thorakaler V. cava inferior und Sinus coronarius berechneten wir Lactat/Pyruvat-Quotienten, das Redoxpotential des L/P-Systems, das exess lactate und die anaerobe Stoffwechselrate nachHuckabee. Die anaerobe Stoffwechselrate stieg im Cava inferior-Gebiet auf rund 9% im Schock an, eine Zunahme des anaeroben Herzstoffwechsels war dagegen bei systolischen Blutdruckwerten von 32,1±0,7 mm Hg wahrend maximal 90 min nicht nachweisbar. Die verwendeten Kriterien des Sauerstoffmangels und die Beziehungen der vorgelegten Ergebnisse zu den Befunden anderer Autoren werden diskutiert.

Die regionale Verteilung des Sauerstoffmangels im experimentellen hämorrhagischen Schock

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Regional differences of the lactate-pyruvate response to progressive arterial hypoxemia.

Die regionale Verteilung des Sauerstoffmangels im experimentellen hämorrhagischen Schock