Background: Although glucose uptake is increased in chronically hypoperfuse
d, viable myocardium, the dynamic changes in glucose uptake relative to oxy
gen consumption in "short-term" models of hibernation have not been fully e
xplored.
Methods: 14 anesthetized swine were instrumented with an hydraulic occluder
and flow probe on the proximal LAD artery. Blood flow was reduced similar
to 30 % for 1 hour. Myocardial blood how and uptake of oxygen, free fatty a
cids, glucose and lactate were determined in the LAD region at baseline and
at 10, 30, and 60 minutes of ischemia. Transmural biopsies for ATP and cre
atine phosphate (CP) were obtained in the LAD region prior to and at 15 and
45 minutes of ischemia. In 5 animals, glycogen was assayed at baseline and
at the end of 60 minutes of ischemia.
Results: In the LAD region, myocardial oxygen consumption was reduced from
2.06 +/- 0.16 mu mol/min/gram to 1.46 +/- 0.13 mu mol/min/gram (P < 0.05).
By 15 minutes of ischemia, transmural creatine phosphate fell from 7.48 +/-
0.76 mu mol/g-wet weight at baseline to 6.19 +/- 0.32 mu mol/g-wet weight
(P < 0.05) but normalized by 45 minutes of ischemia (7.39 +/- 0.56 mu mol/g
-wet weight; NS). Between 10 and 60 minutes of constant flow reduction, glu
cose uptake as a percentage of MVO2 increased from 3 +/- 2 % to 10 +/- 2 %
(P < 0.05) while lactate uptake increased from -9 +/- 9 % to -1 +/- 2 % (P
< 0.05). Glycogen decreased from 27.8 +/- 3.7 at baseline to 16.9 +/- 1.2 m
u mol/g-wet weight at end-ischemia.
Conclusions: In this model of short-term hibernation, glucose and lactate u
ptake increase relative to oxygen consumption during sustained ischemia, an
d temporally coincide with the recovery of bioenergetics. The findings are
consistent with the notion that glycolytically derived ATP is important for
the maintainance of energy supply during sustained ischemia.