Comparison between metabolic changes in local venous and coronary sinus blood after acute experimental coronary arterial occlusion

Abstract

A technique for the study of local metabolic changes in coronary venous blood draining from a small area of ischemic myocardium is described. Overt left ventricular failure, ventricular arrhythmias and possible secondary effects on local metabolic changes were avoided. Metabolic changes in local coronary venous blood and in coronary sinus blood were compared. Gross changes detected by local coronary venous sampling were not observed in coronary sinus blood samples. The possible relevance of this observation to clinical studies was noted. The small ischemic lesion usually involved less than 10 percent of the heart volume and was characterized by acute S-T segment elevation in the epicardial electrocardiogram and by positive changes in values for local coronary venous blood lactate, pyruvate, lactate/ pyruvate ratio, glucose, potassium and phosphate. Free fatty acids and beta hydroxybutyrate and acetoacetate levels were also studied. The technique and its results are compared with other methods of study of the metabolism of ischemic heart tissue.