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Transmural Gradient in High-Energy Phosphate Content in Patients with Coronary Artery Disease
Journal article   Open access   Peer reviewed

Transmural Gradient in High-Energy Phosphate Content in Patients with Coronary Artery Disease

Robert N. Jones, Robert B. Peyton, Richard L. Sabina, Judith L. Swain, Edward W. Holmes, Thomas L. Spray, Peter Van Trigt and Andrew S. Wechsler
The Annals of thoracic surgery, v 32(6), pp 546-553
Dec 1981
PMID: 6976154
url
https://doi.org/10.1016/S0003-4975(10)61795-XView
Published, Version of Record (VoR) Open

Abstract

In 16 patients undergoing elective coronary artery bypass, transmural biopsies were performed during bypass but before global ischemia. Subendocardial and subepicardial halves were separately assayed in each sampled tissue. Adenosine triphosphate (ATP) levels, total adenine nucleotide content (ΣAd), and creatine phosphate (CP) content were significantly higher ( p < 0.005) in the subepicardium than the subendocardium in regions of the heart distal to major occlusions: 35.36 ± 2.12 nmole/mg versus 28.7 ± 1.7 (ATP), 42.24 ± 2.04 versus 35.6 ± 1.6 (ΣAd), and 29.99 ± 4.32 versus 16.35 ± 3.48 (CP). The opposite was true in two hearts with normal coronary arteries, in which high-energy phosphates tended to be higher in the subendocardium than the subepicardium. A transmural metabolic gradient therefore exists in regions of the myocardium distal to significant coronary occlusive disease. The subendocardium's relative depression in metabolic reserve could determine its susceptibility to ischemic damage and influence techniques designed to preserve the heart during ischemia.

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Web of Science research areas
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
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