Download Cardiac Energetics: Basic Mechanisms and Clinical by Dr. B. Brenner, E. Eisenberg (auth.), R. Jacob, Hj. Just, PDF

By Dr. B. Brenner, E. Eisenberg (auth.), R. Jacob, Hj. Just, Ch. Holubarsch (eds.)

Assessment of cardiac energetics on the point of ATP-synthesis, chemomechanical strength transformation and entire organ dynamics as a functionality of haemodynamic load, ventricular configuration and oxygen- and substrates offer is simple to realizing cardiac functionality lower than physiological and pathophysiological (hypertrophy, hypoxia, ischaemia and middle failure) stipulations. additionally, cardiac energetics can be an immense attention within the selection and alertness of gear specially relating to vasodilators, inotropic brokers and in cardioprotective measures. purely by means of contemplating energetics on the subcellular, mobile, and whole-heart point we will be able to arrive at a greater figuring out of cardiac functionality and eventually greater medical judgement and drug remedy. Quantification of myocardial energetics also will aid to figure out the optimum time for surgical interventions resembling valvular substitute or aneurysm resection. the current quantity is the result of a world symposium on cardiac energetics held in Gargellen/Montafon (Austria), June 1986. The contributions will surely support bridge the prevailing hole among simple examine concerning remoted buildings and that related to the full organ, at the one hand, and render the implications derived from easy study appropriate to medical difficulties, at the different hand.

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Additional resources for Cardiac Energetics: Basic Mechanisms and Clinical Implications

Example text

E. the differences between equilibrium and non-equilibrium reactions and the inverse relationship between efficiency and energy flux. Chemical equilibrium conditions are comparable with the state of connected reservoirs with the same level of fluid on either side. e. with 100% efficiency, but energy cannot be drawn from this system. To generate flow or to draw energy from a system a gradient must be created. e. entropy production, in the form of heat, the efficiency declines accordingly. The energy metabolism of the cell can be considered to begin with the oxidation of glucose which yields about 2850 kJ Imol (Fig.

It varies with metabolic substrate as already hinted in Fig. 2 B. Chapman and Gibbs [6] showed that pyruvate increased the basal heat rate of rabbit papillary muscle by nearly 50% with respect to glucose. Lactate and acetate had intermediate effects (Fig. 3 A). Gibbs & Kotsanas [23] have confirmed this result in the rabbit heart arrested by perfusion with low Ca + +; a mixture of glutamate, pyruvate and fumarate caused a 30% increase in basal oxygen consumption despite a 40% decrease in coronary flow.

This is rather close to the 100% characterizing equilibrium conditions and consequently, the Ca + + loading capacity of the SR should change with the free energy level of ATP and the SR Ca + + -ATPase reaction should also be reversed under certain conditions, as already demonstrated in vitro [2]. The energy level required for the sarcolemmal sodium/ potassium ATPase of 46 kJ/mol of ATP (76% of the level available) is also still high, and the transfer can be expected to also depend to a certain extent on the energy level available.

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