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IN THE NORMAL HEART, coronary flow myocardial energy metabolism may vary widely, but because they remain closely matched, ATP concentration remains constant. During myocardial the normal matching of flow--metabolism is disturbed, the rate of cellular ATP synthesis falls below that of ATP utilization, leading to a progressive depletion of tissue content of ATP creatine phosphate. Cell death results if ATP levels fall to a critical value of approximately 10% of normal (20). During there is a reduction in myocardial metabolism because the decrease in contraction causes a lowering in the rate of ATP utilization, tending to restore energy balance delay ATP depletion. This adaptive response may be related to the partial recovery of creatine phosphate 0363-6135/95 $3.00 Copyright during myocardial âhibernationâ (Z), the reversible decrease in myocardial contraction due to coronary underperfusion (34). In myocardial metabolism is stimulated with catecholamines in the presence of a flowlimiting coronary artery stenosis. ischemia also causesdisturbances in the matching of flow metabolism, since there were decreases in regionaeft ventricular mechanical performance (1 l), decreases in the ratio of creatine phosphate to ATP concentrations (31), evidence of myocardial hypoxia (30). Dobutamine sti .mulation of underperfused myocardium causes increased depletion of creatine phosphate ATP
AJP - Heart and Circulatory Physiology – The American Physiological Society
Published: Sep 1, 1995
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