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Ann Thorac Surg 1975;20:21-29
© 1975 The Society of Thoracic Surgeons

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Articles

Biochemical Changes of Ischemia

From the Departments of Surgery and Pharmacology, Abraham Lincoln School of Medicine and School of Basic Medical Science, University of Illinois College of Medicine, Chicago, Ill.

^* Address reprint requests to Dr. Levitsky, Department of Surgery, Abraham Lincoln School of Medicine of the University of Illinois College of Medicine, P.O. Box 6998, Chicago, Ill. 60680.

Normothermic ischemic arrest by aortic cross-clamping, a widely used clinical technique, is associated with metabolic changes in the myocardium that are incompletely understood. The effects of aortic cross-clamping on glycolytic pathways as well as associated morphological changes are discussed. Emphasis is placed on the conservation of high-energy phosphate moieties during the period of cross-clamping as well as during reperfusion. A marked reduction in total high-energy phosphates (62%) and glycogen (63%) and an increase in lactate production (243%) denote a shift to anaerobic metabolism during the period of arrest. Despite reperfusion, total high-energy nucleotides remained depressed. The data suggest that persistent abnormal myocardial carbohydrate metabolism and low levels of high-energy nucleotides prevent recovery of contractility following normothermic ischemic arrest and reperfusion.

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