Improved visualization of the human lung in 1H MRI using multiple inversion recovery for simultaneous suppression of signal contributions from fat and muscle

1H magnetic resonance imaging of the lung is hampered by the low contrast between lung parenchyma, and muscle and fat in the thorax. We show that it is possible to improve contrast greatly and thereby enhance the visibility of the lung, by suppression of signal of surrounding muscle and fat based on differences in T1 relaxation times using a double inversion recovery preparation pulses (TI1 800 msec, and TI2 150 msec) and a half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence. The measured T1 values for the right and left lungs at 1.5 T were 1.37 +/- 0.18 and 1.41 +/- 0.21 sec, respectively.

Improved visualization of the human lung in 1H MRI using multiple inversion recovery for simultaneous suppression of signal contributions from fat and muscle

1H magnetic resonance imaging of the lung is hampered by the low contrast between lung parenchyma, and muscle and fat in the thorax. We show that it is possible to improve contrast greatly and thereby enhance the visibility of the lung, by suppression of signal of surrounding muscle and fat based on differences in T1 relaxation times using a double inversion recovery preparation pulses (TI1 800 msec, and TI2 150 msec) and a half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence. The measured T1 values for the right and left lungs at 1.5 T were 1.37 +/- 0.18 and 1.41 +/- 0.21 sec, respectively.

Perfusion imaging of the human lung using flow-sensitive alternating inversion recovery with an extra radiofrequency pulse (FAIRER)

Pulmonary perfusion is an important parameter in the evaluation of lung diseases such as pulmonary embolism. A noninvasive MR perfusion imaging technique of the lung is presented in which magnetically labeled blood water is used as an endogenous, freely diffusible tracer. The perfusion imaging technique is an arterial spin tagging method called Flow sensitive Alternating Inversion Recovery with an Extra Radiofrequency pulse (FAIRER). Seven healthy human volunteers were studied. High-resolution perfusion-weighted images with negligible artifacts were acquired within a single breathhold. Different patterns of signal enhancement were observed between the pulmonary vessels and parenchyma, which persists up to TI = 1400 ms. The T1s of blood and lung parenchyma were determined to be 1.46s and 1.35 s, respectively.

MR perfusion imaging of pulmonary parenchyma using pulsed arterial spin labeling techniques: FAIRER and FAIR

Magnetic resonance imaging of pulmonary parenchyma perfusion using pulsed arterial spin labeling (ASL) techniques is presented. ASL uses magnetically labeled water as an endogenous, freely diffusible tracer. Presented are comparative results of ASL methods called Flow sensitive Alternating Inversion Recovery (FAIR), and FAIR with an Extra Radiofrequency pulse (FAIRER). Six healthy human volunteers were imaged. Perfusion-weighted images at different time delays, TI, were calculated from the subtraction of the control and tag images, which were acquired within a single breathhold. Detailed pulmonary structures can be visualized with negligible cardiac or respiratory motion artifacts. Different patterns of signal enhancement between the pulmonary vessels and parenchyma are shown in the perfusion images acquired at different TIs.

Extraslice spin tagging (EST) magnetic resonance imaging for the determination of perfusion

A new magnetic resonance technique to measure perfusion is described in detail. The means by which this is done is to invert all the spins in the radiofrequency RF coil with a non-spatially selective pulse and immediately re-invert the spins in the imaging plane. The net effect is that the spins in the imaging plane experience minimal perturbation of their magnetization while the spins outside the plane (extraslice) are inverted, or tagged. Tagged spins that flow into the imaging plane before image data are acquired decrease the signal intensity in the imaging plane when compared with an image in which the inflowing spins are not tagged. This decrease in signal can be used to calculate the number of spins that have flowed into the imaging plane, i.e., can be used to calculate the perfusion in mL x 100 g(tissue)(- 1)x min(-1). The extraslice spin tagging (EST) magnetization preparation period was coupled with a fast imaging sequence to obtain perfusion maps for normal volunteers.

Gender differences in leptin levels during puberty are related to the subcutaneous fat depot and sex steroids

Little is known about the influence of adiposity and hormone release on leptin levels in children and adolescents. We utilized criterion methods to examine the relationships among sex steroids, body composition (4 compartment), abdominal visceral and subcutaneous fat (magnetic resonance imagery), total subcutaneous fat (sum of 9 skinfolds), energy expenditure (doubly labeled water), aerobic fitness, and serum leptin levels in prepubertal and pubertal boys (n = 16; n = 13) and girls (n = 12; n = 15). The sum of skinfolds accounted for more variance in leptin levels of all girls [coefficient of determination (R2) = 0.70, P < 0.001] and all boys (R2 = 0.60, P < 0.001) than the total fat mass (girls, R2 = 0.52, P < 0.001; boys, R2 = 0.23, P < 0.001). Total energy expenditure, corrected for the influence of fat-free mass, correlated inversely with leptin (R2 = 0.18, P = 0.02). Gender differences in leptin disappeared when corrected for sex steroid levels or the combination of adiposity and energy expenditure. In multiple regression, the sum of skinfolds and free testosterone and estrogen levels accounted for 74% of the variance in leptin levels. We conclude that serum leptin levels are positively related to subcutaneous adiposity but negatively related to androgen levels. Energy expenditure may be negatively related to leptin levels by reduction of the adiposity, or a common genetic factor may influence both the activity and serum leptin levels.

Alterations in growth and body composition during puberty: III. Influence of maturation, gender, body composition, fat distribution, aerobic fitness, and energy expenditure on nocturnal growth hormone release

We examined the relationships among gender, sexual maturation, four-compartment model estimates of body composition, body fat distribution (magnetic resonance imaging for abdominal visceral fat and anthropometrics), aerobic fitness, basal and total energy expenditure, and overnight GH release in an ultrasensitive chemiluminescence assay in healthy prepubertal and pubertal boys (n = 18 and 11, respectively) and girls (n = 12 and 18, respectively). Blood samples were withdrawn every 10 min from 1800-0600 h to determine the area under the serum GH-time curve (AUC), sum of the GH peak heights (sigma GH peak heights), and the mean nadir GH concentration. GH release was greater in the pubertal than prepubertal subjects due to an increase in sigma GH peak heights (43.8 +/- 3.6 vs. 24.1 +/- 3.5 ng.mL-1, P = 0.0002) and mean nadir (1.7 +/- 0.2 vs. 0.7 +/- 0.2 ng.mL-1, P = 0.0002), but not peak number (4.3 +/- 0.2 vs. 4.5 +/- 0.2). The girls had a greater sigma GH peak heights (39.0 +/- 3.5 vs. 28.8 +/- 3.6 ng.mL-1, P = 0.05) and mean nadir concentration (1.4 +/- 0.2 vs. 0.9 +/- 0.2 ng.mL-1, P = 0.05) than the boys. Significant inverse relationships existed between sigma GH peak heights (r = -0.35, P = 0.06) or mean nadir (r = -0.39, P = 0.04) and four-compartment percent body fat for all boys but not for all girls or when combining all subjects. For all girls, significant inverse relationships existed between sigma GH peak heights (r = -0.39, P = 0.03) or mean nadir (r = -0.37, P = 0.04) and waist/hip ratio. Similar inverse relationships in all boys or all subjects were not significant. Forward stepwise regression analysis determined that bone age (i.e. maturation, primary factor) and gender were the significant predictors of AUC, sigma GH peak heights, and mean nadir. The influence of maturation reflects rising sex steroid concentrations, and the gender differences appear to be because of differences in estradiol concentrations rather than to body composition or body fat distribution.

Transgenic A1 adenosine receptor overexpression markedly improves myocardial energy state during ischemia-reperfusion

A1 adenosine (A1AR) activation may reduce ischemia-reperfusion injury. Metabolic and functional responses to 30 min global normothermic ischemia and 20 min reperfusion were compared in wild-type and transgenic mouse hearts with approximately 100-fold overexpression of coupled cardiac A1ARs. 31P-NMR spectroscopy revealed that ATP was better preserved in transgenic v wild-type hearts: 53 +/- 11% of preischemic ATP remained after ischemia in transgenic hearts v only 4 +/- 4% in wild-type hearts. However, recovery of ATP after reperfusion was similar in transgenic (46 +/- 5%) and wild-type hearts (37 +/- 12%). Reductions in phosphocreatine (PCr) and cytosolic pH during ischemia were similar in both groups. However, recovery of PCR on reperfusion was higher in transgenic (67 +/- 8%) v wild-type hearts (36 +/- 8%), and recovery of pH was greater in transgenic (pH = 7.11 +/- 0.05) v wild-type hearts (pH = 6.90 +/- 0.02). Bioenergetic state ([ATP]/[ADP].[Pi]) was higher in transgenic v wild-type hearts during ischemia-reperfusion. Time to ischemic contracture was prolonged in transgenic (13.6 +/- 0.8 min) v wild-type hearts (10.4 +/- 0.3 min). Degree of contracture was lower and recovery of function in reperfusion higher in transgenic v wild-type hearts. In conclusion, A1AR overexpression reduces ATP loss and improves bioenergetic state during severe ischemic insult and reperfusion. These changes may contribute to improved functional tolerance.

MR imaging and spectroscopy using hyperpolarized 129Xe gas: preliminary human results

Using a new method of xenon laser-polarization that permits the generation of liter quantities of hyperpolarized 129Xe gas, the first 129Xe imaging results from the human chest and the first 129Xe spectroscopy results from the human chest and head have been obtained. With polarization levels of approximately 2%, cross-sectional images of the lung gas-spaces with a voxel volume of 0.9 cm3 (signal-to-noise ratio (SNR), 28) were acquired and three dissolved-phase resonances in spectra from the chest were detected. In spectra from the head, one prominent dissolved-phase resonance, presumably from brain parenchyma, was detected. With anticipated improvements in the 129Xe polarization system, pulse sequences, RF coils, and breathing maneuvers, these results suggest the possibility for 129Xe gas-phase imaging of the lungs with a resolution approaching that of current conventional thoracic proton imaging. Moreover, the results suggest the feasibility of dissolved-phase imaging of both the chest and brain with a resolution similar to that obtained with the gas-phase images.

Accuracy of an experimental stereotactic system for MRI-based gamma knife irradiation in the rat

Stereotactic devices for experimental Gamma Knife irradiation and magnetic resonance imaging (MRI) have recently been developed for experimental studies using rats [6,7]. The present study examined the accuracy of these devices using the following two approaches. In the first approach, Gamma Knife irradiation was performed using the stereotactic device with targets based on a standard stereotactic atlas. Gadolinium-enhanced T1-weighted magnetic resonance imaging was performed using the MRI stereotactic device. Animals were then sacrificed after Evans blue injection, and the rat brain was sliced using an attachment to the stereotactic device. The center coordinates of the gadolinium-enhanced area from the MRI and Evans blue-stained area from the tissue sections were obtained using a computer-assisted image analysis system. These coordinates were compared with the target coordinates planned from the stereotactic atlas. In the second approach, a thermoluminescence dosimeter was implanted in the rat brain. Stereotactic MRI was performed using the stereotactic MRI device, and the coordinates of the implant were obtained. Gamma Knife irradiation was then performed at this target using the stereotactic device. The absorbed dose was measured and compared with the planning dose. These experiments demonstrated a spatial error of 0.6 mm (standard error +/- 0.07) between Gamma Knife irradiation based on a comparison of the atlas coordinates and the lesion, and a spatial error of 1.0 mm (standard error +/- 0.13) based on a comparison of the stereotactic MR images and the lesion. Gamma Knife irradiation based on MR images using the stereotactic device demonstrated a maximum error of 10% in absorbed dose at the target center. Together, the stereotactic devices for Gamma Knife irradiation and magnetic resonance imaging provide useful tools for Gamma Knife research in an animal model.

Occlusion of the anterior cerebral artery after Gamma Knife irradiation in a rat

The anterior cerebral artery of rats was irradiated at the level of the circle of Willis by Gamma Knife with a maximum dose of 25, 50, or 100 Gy. Occlusion of the anterior cerebral artery was observed in one rat which was followed for 20 months after irradiation of 100 Gy. Cerebral infarction was found at the midline-frontal region and the cingulate gyrus. Arterial wall thickening with fibrosis, splitting of the internal elastic membrane, luminal organized thrombus, and migration of smooth muscle cells into the thrombus were observed. In the anterior cerebral artery, thrombus formation seemed to occur after the endothelial injury and this may play a prominent role for occlusion. In small arteries, various changes were observed in the irradiated tissue. These included fibrosis and thrombus, thickened smooth muscle layer, lymphocytic infiltration, and thickening of vessel wall with fibrosis and fibrinous thrombosis with leakage of fibrin into the surrounding tissue after different doses of radiation and at different observation times. These changes were comparable to the ordinary vascular response to injury including healing vasculitis and arteriosclerosis.

Focal liver disease: comparison of breath-hold T1-weighted MP-GRE MR imaging and contrast-enhanced CT--lesion detection, localization, and characterization

PURPOSE

To compare breath-hold T1-weighted magnetization-prepared gradient-echo (MP-GRE) magnetic resonance (MR) imaging with contrast material-enhanced computed tomography (CT) in the assessment of focal liver disease.

MATERIALS AND METHODS

The MR and CT images obtained in 64 patients with focal liver disease were reviewed by six independent reviewers in a randomized, blinded fashion. Sets of axial T1-weighted MP-GRE images, three-plane (a compilation of axial, sagittal, and coronal) T1-weighted MP-GRE images, and contrast-enhanced CT scans were analyzed. T2-weighted spin-echo (SE) MR images were also compared with CT scans.

RESULTS

Lesions were detected, localized, and characterized more accurately and generally with greater confidence with three-plane T1-weighted MP-GRE imaging than with CT (P < .01). Axial T1-weighted MP-GRE imaging was also superior (P < .05) to CT (although slightly less superior than three-plane imaging) except in the characterization of specific lesions, where both techniques were equal. T2-weighted SE MR imaging and CT were about equal.

CONCLUSION

Lesion detection, localization, and characterization are performed more accurately and confidently with breath-hold T1-weighted MP-GRE imaging than with contrast-enhanced CT, particularly when breath-hold images are obtained in three planes.

Interstitial adenosine and cellular metabolism during beta-adrenergic stimulation of the in situ rabbit heart

OBJECTIVE

Adenosine, derived from hydrolysis of 5'-AMP, may be involved in coupling coronary blood flow to cardiac function and metabolism. The purpose of this study was to measure interstitial fluid (ISF) adenosine and 5'-AMP levels, and cytosolic 5'-AMP in in situ rabbit heart during beta-adrenergic stimulation.

METHODS

Isoproterenol was infused into open chest rabbits (n = 7) at 1 and 4 micrograms.kg-1.min-1. Left ventricular ISF adenosine and 5'-AMP levels were measured using microdialysis, and energy metabolism simultaneously monitored using 31P-NMR spectroscopy.

RESULTS

Graded beta-stimulation increased heart rate (by 50% and 70%), arterial pulse-pressure (by 55% and 45%), and the rate-pressure product (by 45% and 70%). Dialysate [adenosine] increased 300-400% from a control value of 0.44 +/- 0.13 microM. Dialysate [5'-AMP] increased 200% from a control value of 0.94 +/- 0.22 microM. Cytosolic [ATP], pH and free [Mg2+] remained stable, whereas [PCr] declined by 10-20%. Free cytosolic [5'-AMP] increased 300-400% from a control value of 0.40 microM. Competitive inhibition of ecto-5'-nucleotidase with alpha,beta-methylene-ADP (0.6 mg.kg-1.min-1) significantly reduced ISF adenosine (and enhanced ISF 5'-AMP) during beta-stimulation, but not under basal conditions.

CONCLUSIONS

Beta-adrenergic stimulation increases ISF adenosine levels and depresses bioenergetic state in in situ rabbit heart without altering [ATP], pH or [Mg2+], indicating an absence of "demand" ischemia. ISF adenosine originates primarily from cytosolic 5'-AMP under basal conditions whereas increased adenosine during beta-stimulation appears to occur via hydrolysis of both ISF and cytosolic 5'-AMP. ISF adenosine levels achieved during stimulation are appropriate for stimulation of cardiovascular A1 and A2 receptors.

Integration of vascular, contractile and metabolic responses to hypoxia: effects of maturation and adenosine

We examined myocardial responses to reduced arterial PO2 and the role of endogenous adenosine in constant-pressure perfused hearts from immature (Imm) and mature (Mat) rabbits. During normoxia, coronary flow and myocardial O2 consumption were similar in both groups. With moderate hypoxia, coronary perfusate flow increased by 125 +/- 16% in Imm but by only 68 +/- 12% in Mat hearts. Imm hearts displayed better maintenance of contractile function (87 vs. 67% in Mat hearts) and metabolic state. Blockade of cardiac adenosine receptors with 25 microM 8-p-sulfophenyltheophylline attenuated vasodilation during hypoxia, reduced contractile function, and abolished age-related differences in one response to hypoxia. Myocardial purine release and extracellular purine levels were threefold higher in Mat compared with Imm hearts and was associated with higher cytosolic 5'-AMP concentration (and lower [ATP]/[ADP].[P(i)], where [ATP], [ADP], and [P(i)] are concentrations of ATP, ADP and P(i), respectively) in Mat hearts. In summary, 1) Imm hearts are functionally and metabolically more tolerant of hypoxic perfusion, largely because of improved hypoxia-induced coronary vasodilation; 2) endogenous adenosine mediates this beneficial vasodilation, enhancing hypoxic tolerance; and 3) improved vascular sensitivity to adenosine allows for enhanced vasodilatory responses in the face of lower adenosine levels and higher energy state in immature hearts.

1995 AUR Memorial Award. Gamma knife irradiation-induced changes in the normal rat brain studied with 1H magnetic resonance spectroscopy and imaging

RATIONALE AND OBJECTIVES

The pathogenesis of brain injury following radiosurgery is poorly understood. To better elucidate the relationship between blood-brain barrier disruption and metabolic derangements, we used magnetic resonance (MR) imaging and 1H MR spectroscopy to detect early changes from focused single-fraction, high-dose irradiation injury in rat brains.

METHODS

Using the Leksell gamma knife, we irradiated the frontoparietal cortex of 11 male Wistar rats with a single dose of 120 Gy. Four weeks later, we sequentially performed water-suppressed 1H MR spectroscopy and gadopentetate dimeglumine-enhanced T1-weighted MR imaging. Metabolic maps were created of n-acetylaspartate (NAA), creatine and choline (Cr/Cho), and lactate from the MR spectroscopy data set. Detection of irradiation injury among the tested modalities was assessed by receiver operating characteristic analysis and by quantitative signal intensity changes. Pathologic confirmation of irradiation damage was obtained in all rats.

RESULTS

Gadopentetate dimeglumine-enhanced T1-weighted MR imaging was the only imaging modality that detected statistically significant signal intensity changes (p < .05). No reproducible changes in the metabolites of interest could be detected by 1H MR spectroscopy.

CONCLUSION

In our animal model, blood-brain barrier disruption was a reproducible, integral finding of single-fraction, high-dose irradiation injury. No reproducible metabolic derangements of ischemia or necrosis were detected by 1H MR spectroscopy, possibly because of dose-latency effects or sensitivity issues.

Enhanced magnetic resonance imaging of the rat brain using a stereotactic device with a small head coil: technical note

A stereotactic device (SDM) was developed for performing consistent magnetic resonance imaging (MRI) of the rat brain. The SDM was developed by adapting a radiofrequency transmit/receive head coil of 4.4 cm inner diameter (quadrature birdcage head coil), and utilizing partial acrylic construction for the positioning elements. The small head coil provides improved resolution and accuracy of the image, while the stereotactic holder permits repeatable and accurate imaging of identified brain structures. This system provides several advantages over existing experimental MRI devices. The SDM ensures that the head is always placed in the center of the coil in a uniform fashion. Standardized positioning of the skull optimizes image quality and provides a consistent orientation of the brain. In addition, a widely-utilized coordinate system described by Paxinos and Watson can be employed to assist in the identification of structures and to facilitate surgical planning. The SDM is compatible with a recently-developed stereotactic device for radiosurgery with the Gamma Knife, thus permitting the planning and performance of experimental radiosurgery using the same coordinate system. The SDM also provides the ability to perform MRI and radiosurgery at different times, thus avoiding the need for prolonged anesthesia during an experimental study. Finally, the SDM allows repeated MRI of the same, identifiable positions in the brain during longitudinal experimental studies. The utility of this device is demonstrated here by examining the time course of cerebral damage that evolved within a radiosurgical focus after gamma irradiation.

Assessment of the reliability of the determination of carotid artery lumen sizes by quantitative image processing of magnetic resonance angiograms and images

In order to use MR imaging to assess progression or regression of atherosclerosis, one must have an idea of the reproducibility of the imaging and image processing techniques. The ability of dark-blood MRI and semiautomated image processing to reproducibility measure the inner boundary of the carotid arteries was evaluated and compared with results obtained using bright-blood MRA. MRI and MRA images were obtained for two normal and two diseased volunteers six times each over a short period of time (6 months). The carotid bifurcation was used to align slices from different imaging sessions. The area for each vessel (right and left common, internal and external carotid artery) was determined for the six imaging sessions. The standard deviations of each lumen area normalized to the average area were computed for each vessel segment for each volunteer. For the common, internal, and external carotids, the averaged normalized standard deviations for MRI were 8, 12, and 17% and for MRA were 6, 8, and 13%. Lumen sizes obtained by MRI and MRA were found to be not statistically different. Eccentric plaques not seen on MRA were visualized by MRI. In conclusion, dark-blood MRI with semiautomated image processing yields reliable lumen areas that are in agreement with those obtained by MRA.

Stress radiography of the medial elbow ligaments

PURPOSE

To study the usefulness of stress radiography for evaluation of injury to the medial collateral ligament (MCL).

MATERIALS AND METHODS

Forty-two injured athletes and four healthy athletes without symptoms underwent examination performed with a stress device. The increase in joint space width between the medial epicondyle and coronoid process, measured on anteroposterior radiographs obtained after 0 and 15 daN force was applied to the lateral elbow joint, was used to assess the extent of ligament tear. The validity of this technique was tested with study of selectively severed cadaveric MCLs.

RESULTS

All complete and large partial tears were correctly diagnosed with stress radiography when the increase in joint space width was larger by 0.5 mm in the affected elbow compared with the opposite normal elbow. In subjects with values less than 0.5 mm, the MCLs were normal or showed a small tear that could be managed conservatively.

CONCLUSION

Stress radiography of the MCL enables accurate diagnosis of large and complete tears and distinction between such tears and small partial tears and normal ligaments.

MR imaging of the liver: breath-hold T1-weighted MP-GRE compared with conventional T2-weighted SE imaging--lesion detection, localization, and characterization

PURPOSE

To compare breath-hold T1-weighted magnetization-prepared gradient-echo (MP-GRE) imaging with conventional T2-weighted spin-echo (SE) imaging in evaluation of focal liver disease.

MATERIALS AND METHODS

Images of 68 patients evaluated for focal liver disease were reviewed. Five sets of images were analyzed: axial, sagittal, and coronal breath-hold T1-weighted MP-GRE images, axial T2-weighted SE images, and a compilation of axial, sagittal, and coronal (three-plane) T1-weighted MP-GRE images. Lesion signal intensity (SI) and signal difference-to-noise (SD/N) ratios were calculated.

RESULTS

Lesions were detected, localized, and characterize more accurately (P < .05-.001) and with greater confidence on three-plane T1-weighted MP-GRE images than on almost all single-plane images. Mean SI ratios of nonsolid and solid lesions on MP-GRE and SE images were significantly different at all lesion sizes; mean SD/N ratio was significantly different only for large lesions.

CONCLUSION

Lesion detection, localization, and characterization can be accurately and confidently performed with three-plane T1-weighted MP-GRE breath-hold imaging, potentially obviating conventional T2-weighted SE imaging.

Effects of graded perfusion and isovolumic work on epicardial and venous adenosine and cytosolic metabolism

Epicardial adenosine levels and venous adenosine release were measured in isovolumically contracting (ISO) and empty non-isovolumic (non-ISO) guinea-pig hearts subjected to graded perfusion (approximately 7.5, 5.5, 4.0, 2.0, and 1.0 ml/min/g). Myocardial metabolism was monitored using 31P-NMR spectroscopy. At flows of 5.5 ml/min/g or higher epicardial adenosine levels were stable and comparable in ISO and non-ISO hearts (approximately 160 nM). At flows of 4.0 ml/min/g or higher venous adenosine release was stable and comparable in ISO and non-ISO hearts (approximately 30 pmol/min/g). At lower flows, epicardial adenosine and venous adenosine release both increased and were significantly higher in ISO hearts, compared to non-ISO hearts, at each flow rate. Whereas epicardial adenosine increased linearly in ISO and non-ISO hearts at low flows, venous adenosine release stabilized in ISO hearts perfused at 1.0 ml/min/g. Epicardial adenosine, venous adenosine release, and log [ATP]/[ADP] [Pi] all displayed significant correlations with the O2 supply:demand ratio which were comparable in ISO and non-ISO hearts. Elevated levels of epicardial adenosine were linearly related to log [ATP]/[ADP] [Pi] and cytosolic [AMP] and these relationships were comparable in ISO and non-ISO hearts. Alternatively, changes in venous adenosine release did not display simple relationships with log [ATP]/[ADP] [Pi] and cytosolic [AMP] and they were not comparable in ISO and non-ISO hearts. The data indicate that: (i) myocardial adenosine formation increases only below a metabolic threshold corresponding to log [ATP]/[ADP] [Pi] = 5.0 and O2 supply:demand = 1.5 in ISO and non-ISO guinea-pig hearts; (ii) stimulated epicardial adenosine levels appear to be consistently related to changes in cytosolic metabolism below this threshold in ISO and non-ISO hearts; (iii) more complex relationships exist between venous adenosine release and myocardial metabolism during graded perfusion, possibly reflecting the variety of factors modulating venous adenosine release.

Metabolic correlates of adenosine formation in stimulated guinea pig heart

Adenosine release into epicardial fluid and coronary effluent of isolated isovolumic guinea pig hearts was examined at baseline and after stimulation with norepinephrine (30 nM) during 31P-nuclear magnetic resonance spectroscopy to monitor myocardial metabolism. At baseline flow (9.6 +/- 0.3 ml.min-1.g-1), epicardial and venous adenosine concentrations were 154 +/- 40 and 17 +/- 5 nM, respectively. The phosphorylation potential (log[ATP]/[ADP][Pi]) and the phosphocreatine-inorganic phosphate ratio ([PCr]/[Pi]) were 5.26 +/- 0.04 and 8.5 +/- 0.7, respectively. Norepinephrine increased left ventricular pressure, heart rate, and myocardial O2 consumption rate by approximately 21, 70, and 45%, respectively, and increased epicardial and venous adenosine to 496 +/- 74 and 461 +/- 94 nM, respectively. Log-[ATP]/[ADP][Pi] and [PCr]/[Pi] declined to 4.57 +/- 0.06 and 1.9 +/- 0.3, respectively. Epicardial [AMP] increased from 54 +/- 13 to 123 +/- 24 nM. AMP was not detectable in the venous effluent. Coronary resistance correlated with epicardial and venous [adenosine] (r = 0.86 and 0.90). Epicardial and venous [adenosine] correlated with log[ATP]/[ADP][Pi], [PCr]/[Pi], and cytosolic [AMP]. Hence, interstitial adenosine is linked to cytosolic metabolism and may regulate coronary vascular resistance. Venous adenosine underestimates epicardial adenosine at baseline but more closely approximates epicardial adenosine during norepinephrine infusion.