ADENOSINE ALTERS GLUCOSE USE DURING ISCHEMIA AND REPERFUSION IN ISOLATED RAT HEARTS

Background. Adenosine possesses marked cardioprotective properties, but the mechanisms for this beneficial effect are unclear. The objective of this study was to determine the effect of adenosine given before ischemia or at reperfusion on mechanical function, glucose oxidation, glycolysis, and metabolite levels in isolated, paced (280 beats per minute) working rat hearts. Methods and Results. Hearts were perfused with Krebs-Henseleit buffer containing 11 mM glucose, 1.2 mM palmitate, and 500 muU . mL-1 insulin at an 11.5 mm Hg left atrial preload and 80 mm Hg aortic afterload. Adenosine (100 muM) pretreatment or adenosine (100 muM) at reperfusion markedly increased the recovery of mechanical function (from 44% to 81% and 96%, respectively) after 60 minutes of low-flow ischemia (coronary flow, 0.5 mL . min-1). Glucose oxidation (mumol . min-1 . g dry wt-1) was inhibited during ischemia (from 0.44+/-0.04 to 0.12+/-0.01), and this was not altered by adenosine (100 muM). During reperfusion, glucose oxidation recovered (to 0.38+/-0.02) and adenosine (100 muM), given at reperfusion, further increased glucose oxidation (to 0.52+/-0.06). The rate of glycolysis (mumol . min-1 . g dry wt-1), which was unaffected by ischemia per se, was inhibited by adenosine pretreatment (from 4.7+/-0.3 to 2.6+/-0.3). During reperfusion, glycolysis was also inhibited by adenosine relative to control (3.9+/-0.8) either when present during ischemia (2.6+/-0.6) or during reperfusion (1.4+/-0.4). These effects of adenosine on glucose metabolism reduced the calculated rate of H+ production attributable to glucose metabolism during the ischemic and reperfusion periods. Tissue lactate levels (mumol . g dry wt-1), which increased during ischemia (from 9.3+/-1.1 to 87.4+/-10.3) and then declined during reperfusion (to 26.2+/-3.7), were depressed further by adenosine pretreatment (to 19.7+/-4.1) and by adenosine at reperfusion (to 13.6+/-2.1). ATP levels (mumol . g dry wt-1), which were depressed by ischemia(from 18.1+/-1.1 to 10.6+/-1.3) and tended to be further depressed during reperfusion (to 7.1+/-0.7), were increased by adenosine pretreatment (to 14.1+/-1.2) and by adenosine at reperfusion (to 15.6+/-2.4). Conclusions. The effects of adenosine on glucose metabolism that would tend to decrease cellular acidosis and hence, Ca2+ overload, may explain the beneficial effects of adenosine on mechanical function observed in these hearts during reperfusion after ischemia.