Abstract
Publisher Summary This chapter provides an overview of myocardial preconditioning via adenosine triphosphate (ATP)-sensitive potassium channels. ATP is broken down to adenosine diphosphate (ADP), and under aerobic conditions, ADP is rapidly reconverted to ATP. Under ischemic, hypoxic, or metabolically challenged conditions, ADP is hydrolyzed to adenosine monophosphate (AMP). Under severe ischemic or hypoxic conditions, AMP is converted to inosine monophosphate (IMP) by adenylate deaminase; however, a portion of AMP is also hydrolyzed to adenosine via the activity of nucleotidases. Adenosine is rapidly metabolized to inosine, and then both inosine and IMP are metabolized to hypoxanthine. Hypoxanthine is metabolized to xanthine, and xanthine to uric acid. In the ischemic myocardium, the metabolic products of ATP hydrolysis rapidly accumulate in the interstitial space, and it is thought that the accumulation of adenosine in the interstitial space may initiate myocardial PC.
Published Version
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