Impairment of myocardial calcium homeostasis by antibodies against the adenine nucleotide translocator.

The adenine nucleotide translocator (ANT) is an autoantigen in myocarditis and dilated cardiomyopathy. Carrier-specific antibodies impair myocardial energy metabolism and heart function. They cross-react with a myolemmal calcium channel and alter calcium fluxes in isolated myocytes. To test whether antibodies against the ANT can alter calcium homeostasis in intact hearts, guinea pigs were immunized with the carrier protein and their isolated hearts loaded with the intracellular calcium indicator INDO-1. The diastolic and systolic ratios of fluorescence signals at 410 nm and 510 nm (emission wavelengths of the calcium-bound and calcium-free indicator), 'd-s410/510', were measured by excitation at 364 nm. This index of the transient calcium concentration associated with the contraction cycle correlated with the external heart work (EHW) in non-immunized controls. EHW of immunized animals was lower (76 +/- 62 vs 153 +/- 47 mJ/g/min in controls, p < 0.005) and the amplitude of d-s410/510 was elevated (27.6 +/- 4.1% of the average ratio of the whole heart cycle vs 21.7 +/- 1.2% in controls, p < 0.005) and essentially independent of EHW. Isoproterenol stimulation increased EHW in all hearts but d-s410/510 was hightened in control hearts, only. Thus, a disorder between cytosolic calcium transients and work was recorded in hearts from guinea pigs immunized with the ANT. It may contribute to an immunopathic mechanism of heart failure subsequent to myocarditis.

Effect of substrate on mitochondrial NADH, cytosolic redox state, and phosphorylated compounds in isolated hearts.

The effect of metabolic substrates on the relation among cytosolic redox state (NADHc/NAD+) mitochondrial NADH (NADHm), and [ATP]/([ADP] x [Pi]) was studied in isolated working rabbit hearts. Substrates were varied from 5.6 mM glucose alone to glucose in combination with 10 mM lactate and/or 10 mM pyruvate while afterload and preload were held constant. Changes in NADHm were determined from epicardial NADH fluorescence. The ratio of glycerol 3-phosphate (G-3-P) to dihydroxyacetone phosphate (DHAP), determined from tissue extracts, was used as an index of cytosolic redox. Myocardial 31P metabolites were measured using nuclear magnetic resonance spectroscopy. The addition of pyruvate to the perfusion medium caused increases in myocardial oxygen consumption (MVo2), NADHm fluorescence, phosphocreatine (PCr), and [ATP]/([ADP] x [Pi]) and a decrease in NADHc/NADc+ (decreased G-3-P/DHAP). Although the addition of lactate to the perfusion medium caused an increase in NADHm similar to pyruvate, MVo2 and PCr did not change significantly, [ATP]/([ADP] x [Pi]) increased less than with pyruvate, and there was an increase in NADHc/NADc+. The findings suggest that variations in the cytosolic redox state do not necessarily result in obligatory changes in either the mitochondrial redox state or in the [ATP]/([ADP] x [Pi]). This implies that under the conditions of this study an equilibrium is not maintained between [ATP]/([ADP] x [Pi]) and NADHc/NADc+. Furthermore, similar levels of NADHm can be associated with different values for [ATP]/([ADP] x [Pi]) and MVo2, depending on the substrates available to the heart.

The relationship between phosphorylation potential and redox state in the isolated working rabbit heart.

The effects of the cytosolic and mitochondrial redox state on the function and phosphorylation potential of working perfused rabbit hearts were studied. Hearts were perfused with glucose, while lactate, aminooxy-acetate (an inhibitor of the malate-aspartate shuttle), beta-hydroxybutyrate, and pyruvate were sequentially added to the perfusate to manipulate the cytosolic and mitochondrial NAD+/NADH ratio. The phosphorylation potential and product of ADP and P(i) were both found to be proportional to mitochondrial redox state. There was no overall relationship between cytosolic redox potential and the ATP/ADP x P(i) ratio, although at high mitochondrial NADH, there was a tendency for the states with more reduced cytoplasm to be associated with a lower phosphorylation potential. Cardiac output and dP/dt were decreased after 75 microM aminooxy-acetate was present for 15 min, and remained low when 0.5-1.0 mM beta-hydroxybutyrate was added, even though the beta-hydroxybutyrate period was characterized by both very low cytosolic NAD+/NADH and high mitochondrial NADH. Function returned to normal when the cytoplasm was oxidized by addition of 10 mM pyruvate, and although MVO2 rose from 4.0 +/- 0.4 to 5.0 +/- 0.5, this was not accompanied by statistical changes in either mitochondrial NADH or phosphorylation potential. Therefore, the cytosolic redox state may play a role in cardiac function, but has only a minor contribution to the regulation of the phosphorylation potential in the working perfused rabbit heart.

Comparison of EPI gradient-echo contrast changes in cat brain caused by respiratory challenges with direct simultaneous evaluation of cerebral oxygenation via a cranial window.

A gradient-echo echo planar imaging (EPI) sequence has been used to generate images of cat brain during respiratory challenges. Direct spectrophotometric measurements have been made simultaneously in order to correlate the changes in oxygen saturation as measured by spectrophotometry with the image intensity changes seen in the gradient-echo images. When blood volume remains approximately constant, as derived from the spectrophotometry data, good correlation is seen between calculated plots made of changes in the transverse relaxation rate, delta R2*, and the oxygen saturation as measured by spectrophotometry for much of the time course of the respiratory challenges of anoxia, apnea and hypercapnia. In some cases, the correlation is poorer during the recovery periods of the apnea and anoxia challenges. Those lower correlations can often be accounted for by changes in blood volume, which also affects the NMR relaxation rate. These results contribute to the understanding of the image intensity changes seen during functional brain imaging studies in humans.

Effects of afterload and heart rate on NAD(P)H redox state in the isolated rabbit heart.

NAD(P)H redox state was monitored using surface fluorescence in isolated, normothermic, working rabbit hearts under conditions of limited substrate (glucose alone) and abundant substrate (glucose + lactate). To alter work, afterload was varied between 75 and 150 cmH2O or heart rate was increased in steps until no further increase in myocardial oxygen consumption (MVO2) occurred. Alterations in afterload did not cause a significant change in NAD(P)H fluorescence. Progressive increases in heart rate did not alter NAD(P)H emission until MVO2 began to decline (approximately 300 beats/min), ventricular performance decompensated, and there was evidence of ischemia, at which time NAD(P)H fluorescence increased. Although the addition of 3 mM lactate to the perfusate resulted in a rapid increase in NAD(P)H fluorescence, NAD(P)H fluorescence still did not respond to altered workload. The results suggest that NAD(P)H redox state is not the primary stimulus for increased myocardial respiration secondary to tachycardia or afterload. However, despite increased rates of cardiac work, NAD(P)H was maintained at a relatively stable level, suggesting that reducing equivalent supply to the electron transport chain increases in parallel with increased MVO2.

ATP-sensitive potassium channel is essential to maintain basal coronary vascular tone in vivo.

Glibenclamide, a known selective inhibitor of ATP-sensitive potassium channels, was infused into the coronary vasculature of anesthetized dogs and of isolated perfused rabbit hearts to assess the role of this channel in the maintenance of basal coronary resistance. Infusion of glibenclamide at a concentration of 55-80 microM in the dogs resulted in a twofold steady-state increase in coronary resistance with resultant tissue ischemia. Infusion of 1 microM glibenclamide in the isolated hearts resulted in a 67% increase in coronary resistance with resultant tissue ischemia. The ischemic changes were reversible upon removal of the drug. These findings indicate that the ATP-sensitive K+ channel plays a significant role in the maintenance of basal coronary resistance in vivo. Higher concentrations of glibenclamide (80-100 microM) in the in vivo dog heart consistently gave rise to an oscillating pattern of coronary flow. These oscillations were either eliminated or decreased in amplitude and frequency by the infusion of 8-phenyltheophylline, a specific competitive inhibitor of adenosine receptors. 31P-nuclear magnetic resonance spectroscopy performed at the peaks and troughs of these oscillations revealed oscillation of the phosphorylation potential at the same frequency. Thus adenosine release caused by tissue ischemia appears to play a major role in creating the oscillating pattern of coronary blood flow, that occurs during the inhibition of ATP-sensitive K+ channels by glibenclamide.

Myocardial oxygenation in the isolated working rabbit heart as a function of work.

Myocardial O2 consumption (MVO2) was stimulated up to two-fold by either increasing afterload or beta-receptor stimulation in working normothermic isolated rabbit hearts while noninvasively monitoring the O2 delivery or phosphate compounds (total n = 48). Intracellular O2 delivery was estimated with the use of myocardial optical absorbance changes centered at 603.5 and 582 nm that correlate with cytochrome aa3 redox and myoglobin oxygenation states. Phosphate-containing metabolites (ATP, phosphocreatine, free ADP) were assessed using 31P nuclear magnetic resonance spectroscopy. Measurements were made both with intact autoregulation and after maximal vasodilation by 1 microM nitroprusside (NP). When afterload was used to increase MVO2, absorbance decreased at 603.5 nm and increased at 582 nm, consistent with a 10-15% increase in myocardial oxygenation, without an associated change in cardiac phosphate compounds. NP caused a further increase in myocardial oxygenation and venous PO2 consistent with an increase in the O2 supply-to-demand ratio. Increases in MVO2 due to beta-stimulation alone were not associated with changes in 603.5-nm absorbance or phosphate compounds, but in combination with NP were accompanied by increased oxygenation, venous PO2, and cardiac phosphocreatine. KCl arrest caused maximal increases in oxygenation and phosphocreatine. These findings suggest that neither cytochrome aa3 nor myoglobin in the isolated working rabbit heart is fully oxidized or oxygenated, respectively. Furthermore, the oxygenation state of the tissue varied both with afterload-induced changes in cardiac work and with changes in O2 supply/demand.

Effect of work on intracellular calcium of the intact heart.

Intracellular calcium has been proposed to play a key role in the orchestration of metabolic rate with contractile activity in the mammalian heart. Calcium is believed to accomplish this task by modulating the contractile apparatus as well as the metabolic process directly, and perhaps simultaneously, during alterations in cardiac work. The purpose of this study was to evaluate whether appropriate changes in intracellular calcium accompany alterations in cardiac work in the intact working rabbit heart. A range of myocardial oxygen consumption was obtained from 0.94 to 6.51 mumol.g LV wt-1.min-1 by changing afterload or beta-agonist addition. With the increase in work and associated increase in respiration, an increase in intracellular calcium was observed, on the basis of indo-1 fluorescence. These results indicate that intracellular calcium is a valid candidate as a cytosolic transducer contributing to the orchestration of myofibril adenosinetriphosphatase activity and oxidative phosphorylation in the intact heart.

Magnetization transfer contrast in MR imaging of the heart.

The use of magnetization transfer contrast (MTC) in short-echo-time (TE) cardiac magnetic resonance (MR) imaging was evaluated. For most cardiac MR imaging protocols, either long TE and short repetition time or exogenous intravascular agents are used for generating contrast between the ventricular wall and cavity as well as detecting pathologic conditions of the ventricular wall. The major problem with long-TE images is that the motion of the heart degrades the spatial resolution of the image during the TE period. However, MTC is generated by an off-resonance irradiation during the interpulse delay period that is relatively insensitive to motion artifacts. Short-TE (5-15 msec) gradient-recalled echo sequences were used for imaging the heart with and without MTC. These studies revealed that MTC can be used to greatly improve the contrast between the myocardial wall and blood chamber in short-TE images and may provide useful parameters for tissue characterization in pathologic cardiac muscle.

Effects of beta-hydroxybutyrate on oxidative metabolism and phosphorylation potential in canine heart in vivo.

beta-Hydroxy-butyrate (HBA) is an effective substrate for mitochondrial respiration (MVO2) in the heart. Myocardial HBA oxidation is associated with high mitochondrial NADH and an inhibition of glycolytic flux. The purpose of this study was to investigate if the infusion of HBA in vivo could modify the coupling mechanisms between myocardial MVO2 and work in the presence and absence of epinephrine. The extraction of several oxidized metabolites, O2, and HBA was measured during the infusion of HBA as well as the high-energy phosphate metabolites using 31P-nuclear magnetic resonance spectroscopy. HBA infusion did not affect the MVO2 or function of the heart with or without epinephrine infusion. However, HBA increased the phosphorylation potential by decreasing inorganic phosphate and the calculated free ADP concentration under both conditions. This is consistent with HBA increasing the mitochondrial NADH, which results in an increase in the phosphorylation potential without modifying function. These data demonstrate that substrates, specifically HBA, can modulate the cardiac phosphorylation potential in vivo. The most likely mechanism for this effect is through the mitochondrial NADH concentration.

NMR spectral analysis of kinetic data using natural lineshapes.

An automated rapid data analysis scheme for NMR spectroscopy time course studies is presented. This method uses a high signal-to-noise reference spectrum collected at the beginning of a time course as a lineshape model to analyze subsequent low signal-to-noise data collected with higher time resolution. The method is fast (approximately 1 s to evaluate two peaks in a 2K spectrum) and easily implemented on NMR spectrometer computers. An application of this method to spectroscopic studies on the heart is provided.

Effects of tissue absorbance on NAD(P)H and Indo-1 fluorescence from perfused rabbit hearts.

The effects of tissue optical absorbance on intracellular NAD(P)H and Indo-1 fluorescence emission have been evaluated in the perfused rabbit heart. These results demonstrate that the tissue optical absorbance significantly modifies the emission characteristics of these fluorophores. This tissue 'inner filter' effect, observed with both probes, changed as a function of tissue oxygenation and redox state in a wavelength-dependent manner. Pathlength calculations from these results indicate that this inner filter effect could occur with a mean pathlength of 310 microns due to the extremely high extinction coefficient of heart tissue. It is concluded that tissue optical absorbance significantly affects the fluorescent emission characteristics of both intrinsic and extrinsic probes in the intact heart, under a variety of conditions. Several potential methods of correcting for these tissue inner filter effects are discussed.

Phosphorus-31 nuclear magnetic resonance analysis of transient changes of canine myocardial metabolism in vivo.

The time course of the relative myocardial phosphocreatine and adenosine triphosphate contents (PCr/ATP) during step changes in heart rate in vivo was studied in 14 dogs using 31P nuclear magnetic resonance (NMR) to determine if transient changes in the high energy phosphates occur with changes in cardiac work. Coronary sinus blood flow (CF), oxygen consumption (MVO2), and NMR data were simultaneously measured during brief (approximately 3 min), paced increases in heart rate in these open chest animals. 31P spectra were collected with a time resolution of 15-16 s (PCr signal to noise 22-41:1). Paced tachycardia associated with increased CF and MVO2 had no significant transient or sustained effect on PCr/ATP. Higher heart rates, associated with decreased CF and blood pressure, caused rapid decreases of PCr/ATP that were reversible upon return to control rates. These data indicate that there are no transient changes in 31P metabolites (on a 15-16-s time base) during step changes in cardiac work associated with increased CF. This lack of change demonstrates that ATP hydrolysis and production are closely matched and that the feedback mechanism linking these processes occurs rapidly with no detectable transient change in the phosphate metabolites. In contrast, when the CF response to tachycardia is insufficient PCr is quickly depleted. This latter result suggests that the PCr/ATP ratio may be a sensitive, rapidly responding indicator of coronary supply/demand mismatching in vivo.

Control of mitochondrial respiration in the heart in vivo.

After reviewing the controversies in the literature surrounding the regulation of oxidative phosphorylation, a unifying theory to integrate the disparate results would be welcome. Following the traditional biochemical approach to identifying sites of control, one searches for the rate-limiting step in a series of reactions (i.e. a biochemical pathway) that, presumably, will not be at equilibrium. This approach has not succeeded in locating a reaction in cardiac respiratory control that is singularly rate-limiting and may actually be contributing to, rather than clarifying, the problem. There are two major criticisms of this approach. First, even if the step is in disequilibrium, it does not prove that it is rate-limiting (26). Second, a reaction near equilibrium can contribute to regulation of a system (37). In a complex, multiple-reaction integrated pathway such as mitochondrial respiration there are many steps that could potentially share the control of the overall system. Thus this pathway easily lends itself to the possibility of multiple sites of control, each of which could contribute by varying degrees to regulation. In Figure 3 we present one possible network (undoubtedly incomplete) for the distributed control of respiration, which incorporates contributions by the cellular redox state (supply), phosphate metabolite concentrations (either kinetic or thermodynamic), and oxygen. The coordination of the dehydrogenases, phosphate metabolites, and myosin ATPase activity (work) may be orchestrated by a second messenger. Calcium is an attractive candidate for this role (15) as it simultaneously can modulate reducing equivalent supply via the dehydrogenases and ATP use by the myofibrils. The theory of shared control along the path of respiration is not new (37), and has been gaining support from a variety of laboratories (3, 9, 26). Applying this concept to the experimental setting, the relative control strengths for various steps in oxidative phosphorylation have been reported for isolated mitochondria (26). The control coefficients for respiration in isolated myocytes or hearts in vivo remain unknown at this time. If control of respiration occurs at multiple sites, it could account for much of the disagreement in the literature. Experimental conditions, whether intentional or inadvertent, that saturate one or more control mechanisms will increase the relative effect of the other regulatory sites on the remaining range of mitochondrial function. If, for example, the medium surrounding isolated myocytes is such that the cytosolic redox state and pO2 are very high, the phosphate metabolite concentrations could logically be expected to be a major factor influencing the observed rate of oxidative phosphorylation.(ABSTRACT TRUNCATED AT 400 WORDS)

Control of mitochondrial respiration in the heart in vivo.

The role of the hydrolysis products of adenosine triphosphate (ATP), adenosine diphosphate (ADP) and inorganic phosphate (Pi), in the control of myocardial respiration was evaluated in vivo using 31P NMR. These studies were conducted to evaluate whether increases in the ATP hydrolysis products can be detected through the cardiac cycle or during increases in cardiac work. 31P NMR data acquisitions gated to various portions of the cardiac cycle (50 msec time resolution) revealed that cytosolic ATP, ADP and Pi did not change over the course of the cardiac cycle. These metabolites were also monitored during steady-state increases in cardiac work in conjunction with measurements of coronary blood flow and oxygen consumption. No changes were observed during 2 to 3 fold increases in myocardial oxygen consumption induced by various methods. These results demonstrate that the cytosolic ATP, ADP, and Pi concentrations remain relatively constant throughout the cardiac cycle and during physiological increases in cardiac work and oxygen consumption. Furthermore, it is shown that ADP and Pi cannot be solely responsible for the regulation of cardiac respiration in vivo based on the in vitro Km values of these compounds for oxidative phosphorylation. It is concluded that other mechanisms, working in concert with the simple kinetic feedback of ATP hydrolysis products, must be present in the cytosol to provide control of myocardial respiration in vivo.

Developmental changes in the relation between phosphate metabolites and oxygen consumption in the sheep heart in vivo.

This study examines the role of phosphate metabolites in the regulation of mitochondrial oxygen consumption of the heart in vivo as a function of development. We used an open chest lamb/sheep preparation in which myocardial oxygen consumption (MVO2) was monitored via an extracorporeal shunt from the coronary sinus. Phosphate metabolites were monitored simultaneously using 31P nuclear magnetic resonance with a surface coil overlying the left ventricle. Graded infusions of epinephrine were used to increase MVO2 in both neonatal lambs (age 5-12 d, n = 8), and mature sheep (26-86 d, n = 6). The maximal increase in MVO2 achieved was 220 +/- 38% in the newborns and 350 +/- 66% in the mature animals. Associated with these increases in MVO2 in the newborn lambs are significant (P less than 0.001) decreases in PCr/ATP, and increases in calculated ADP and intracellular Pi. This was in contrast to the mature sheep, in which there were no significant changes in PCr/ATP, ADP, or Pi. In conclusion, we find that (a) there are changes in PCr/ATP, Pi, and ADP in newborn animals with moderate increases in work that are not apparent in mature animals of the same species and (b) that these changes suggest that cytosolic ATP hydrolysis products may be more important in regulation of myocardial energy metabolism in the newborn than in the adult.

Simultaneous monitoring of coronary blood flow and 31P NMR detected myocardial metabolites.

We report a method of dynamically measuring coronary blood flow in lambs, while simultaneously monitoring cardiac phosphate metabolism with 31P NMR at 81 MHz. This method uses an ultrasonic transit time probe in conjunction with a 4.7-T CSI spectrometer with a 33-cm magnet bore.

Analysis of epinine and its metabolites in man after oral administration of its pro-drug ibopamine using high-performance liquid chromatography with electrochemical detection.

Ibopamine (N-methyldopamine O,O'-diisobutyrol ester, hydrochloride) is an ester prodrug of epinine. Epinine is a cardiovascular agent used in congestive heart failure because of its dopaminergic and adrenoreceptor agonist properties. Quantitative analytical methods, using high-performance liquid chromatography coupled with electrochemical detection, were developed for the determination of epinine and its known metabolites in biological media. Epinine was extracted from human plasma and urine via an alumina adsorption procedure; this procedure was also used to estimate epinine conjugates after prior enzymatic hydrolysis. Penicillamine was added to the incubation mixture to inhibit isoquinoline production. Urinary dihydroxyphenylacetic acid levels were obtained using the same alumina adsorption procedure, while a separate analytical procedure utilizing a direct high-performance liquid chromatographic analysis of samples was developed for homovanillic acid and its conjugates. Coefficients of variation for all the assays were below 8%. These methods were used to study the pharmacokinetics and metabolic fate of epinine after oral administration of ibopamine to healthy volunteers.

Transmural distribution of intramyocardial pressure measured by micropipette technique.

A technique is presented for measuring intramyocardial pressure (IMP) in beating hearts using the servo-nulling pressure transducer equipped with polyethylene micropipettes (ID less than 12 micron). The static and dynamic response characteristics of the system were tested in a pressurized, saline-filled container as well as in a pressurized, hollow, gelatin cylinder. The system was then used to measure IMP in vivo in the hearts of 12 dogs during stable cardiac performance and with aortic constriction. In vitro response characteristics were found to be satisfactory for accurate reproduction of cardiovascular waveforms. Peak systolic IMP was not found to exceed the simultaneously recorded left intraventricular pressure (LVP). Furthermore, the slope of the regression line relating the IMP to LVP during systole is linearly related (slope 0.98) to the depth of the micropipette tip in the ventricular wall, as normalized to total wall thickness. Diastolic IMP ranged between 1 +/- 1 (minimum during the cardiac cycle) and 4 +/- 2 mmHg (end diastolic) at associated LVP of 2 +/- 2 and 5 +/- 2 mmHg (mean +/- SD), respectively.

Determination of fenoldopam (SK&F 82526) and its metabolites in human plasma and urine by high-performance liquid chromatography with electrochemical detection.

Fenoldopam [6-chloro-2,3,4,5-tetrahydro-1-(4-hydroxyphenyl)-1H-3-benzazepine-7,8-di ol] is a potent renal vasodilator that is currently undergoing Phase II clinical trials. Quantitative analytical methods, based on high-performance liquid chromatography with electrochemical detection (HPLC-ED) after ethyl acetate extraction from plasma or urine were developed for the determination of fenoldopam and its identified metabolites in biological media. The lower limit of quantitation for fenoldopam in plasma was 50 pg/ml. In assays for fenoldopam glucuronide(s) and fenoldopam conjugates, urine was treated with beta-glucuronidase and Glusulase, respectively, and the liberated fenoldopam was quantified by HPLC-ED. A novel assay by dual-electrode (in series) HPLC-ED was developed for the 8-sulfate of fenoldopam. In this method, the 8-sulfate was oxidized to the o-quinone at the first electrode and quantitated at the second electrode after reduction to the catechol. A similar dual-electrode HPLC-ED method was used for 7- and 8-O-methyl fenoldopam. Conjugates of the O-methyl metabolites were determined by HPLC-ED after hydrolysis to O-methyl fenoldopam. These methods have been used to study the kinetics and metabolism of fenoldopam in healthy volunteers. The methods are specific, sensitive, reproducible, and linear over a wide range of concentrations. Precision of the analyses, expressed as coefficients of variation, were less than 10% for all analyses.