PMID: 6976154Dec 1, 1981Paper

Transmural gradient in high-energy phosphate content in patients with coronary artery disease

The Annals of Thoracic Surgery
R N JonesA S Wechsler


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 (sigma Ad), and creatine phosphate (CP) content were significantly higher (p less than 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 (sigma Ad), 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 cold determine its susceptibility to ischemic damage and influence techniques designed to preserve the heart during ischemia.


Oct 1, 1990·Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine·P M RobitailleK Uğurbil
Nov 1, 1984·Progress in Cardiovascular Diseases·R E Fowles, J W Mason
May 1, 1983·Journal of the American College of Cardiology·E R Rosenkranz, G D Buckberg
May 1, 1983·The Annals of Thoracic Surgery·N A SilvermanH Feinberg
Feb 1, 1985·The Journal of Surgical Research·R H BreyerS A Mills
Jul 1, 1996·The Annals of Thoracic Surgery·B S AllenR S Hartz
Dec 1, 1994·The Annals of Thoracic Surgery·H M HanafyR S Hartz
Jul 28, 2016·JACC. Basic to Translational Science·R Croft ThomasPaul C Simpson
Jul 1, 1996·The Annals of Thoracic Surgery·M C MauneyC G Tribble

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