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Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury.

Publication ,  Journal Article
Peyton, RB; Jones, RN; Attarian, D; Sink, JD; Van Trigt, P; Currie, WD; Wechsler, AS
Published in: Ann Surg
September 1982

It is frequently stated that hypertrophied ventricles tolerate ischemia less well than nonhypertrophied ventricles. The authors' earlier studies in a rat supravalvular aortic stenosis model and canine valvular aortic stenosis model, both with concentric left ventricular hypertrophy, disclosed accelerated rates of ischemic contracture and diminished basal myocardial high energy phosphate stores. These studies have been extended to ten patients with severe left ventricular hypertrophy caused by valvular aortic stenosis and normal coronary arteries. ATP (endocardial and epicardial) from transmural left ventricular biopsies taken at operation before aorta cross-clamping, and frozen immediately in liquid nitrogen, were compared with similar biopsies from patients with nonhypertrophied myocardium supplied by normal coronary arteries. The subendocardial high energy phosphate levels in the nonhypertrophied myocardium was greater than high energy phosphate levels in the subepicardium of nonhypertrophied ventricles (ATP-micromoles/gram-protein, epi = 36.8 +/- 3.3, endo = 37.7 +/- 3.3) (p = NS). However, in the hypertrophied myocardium the subendocardium consistently showed significantly depressed high-energy phosphate levels when compared with subepicardial levels (ATP-hypertrophied myocardium, epi = 31.5 +/- 1.6, endo = 25.9 +/- 1.7) (p less than 0.05). This uniform depression of ATP stores, greatest in the subendocardium, in left ventricular hypertrophy suggests a common biologic mechanism for the enhanced sensitivity to ischemia. Of importance for patients may be the prior observation in rats that repletion of ATP( stores before ischemia eliminates the accelerated rate to ischemic contracture. Diminished subendocardial ATP stores appear to be an intrinsic property of severely hypertrophied myocardium and probably contribute to its enhanced sensitivity to ischemia.

Duke Scholars

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

September 1982

Volume

196

Issue

3

Start / End Page

278 / 284

Location

United States

Related Subject Headings

  • Surgery
  • Phosphocreatine
  • Pericardium
  • Myocardium
  • Humans
  • Endocardium
  • Dogs
  • Cardiomegaly
  • Animals
  • Adenosine Triphosphate
 

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Peyton, R. B., Jones, R. N., Attarian, D., Sink, J. D., Van Trigt, P., Currie, W. D., & Wechsler, A. S. (1982). Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury. Ann Surg, 196(3), 278–284. https://doi.org/10.1097/00000658-198209000-00006
Peyton, R. B., R. N. Jones, D. Attarian, J. D. Sink, P. Van Trigt, W. D. Currie, and A. S. Wechsler. “Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury.Ann Surg 196, no. 3 (September 1982): 278–84. https://doi.org/10.1097/00000658-198209000-00006.
Peyton RB, Jones RN, Attarian D, Sink JD, Van Trigt P, Currie WD, et al. Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury. Ann Surg. 1982 Sep;196(3):278–84.
Peyton, R. B., et al. “Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury.Ann Surg, vol. 196, no. 3, Sept. 1982, pp. 278–84. Pubmed, doi:10.1097/00000658-198209000-00006.
Peyton RB, Jones RN, Attarian D, Sink JD, Van Trigt P, Currie WD, Wechsler AS. Depressed high-energy phosphate content in hypertrophied ventricles of animal and man: the biologic basis for increased sensitivity to ischemic injury. Ann Surg. 1982 Sep;196(3):278–284.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

September 1982

Volume

196

Issue

3

Start / End Page

278 / 284

Location

United States

Related Subject Headings

  • Surgery
  • Phosphocreatine
  • Pericardium
  • Myocardium
  • Humans
  • Endocardium
  • Dogs
  • Cardiomegaly
  • Animals
  • Adenosine Triphosphate