Oxygen radicals mediate ultrastructural and metabolic protection of preconditioning in vivo in pig hearts.

Ischemic preconditioning (PC) preserves myocardial high-energy phosphate metabolites and intracellular pH during subsequent sustained ischemia. Generation of reactive oxygen species may be required to mediate PC, as seen in vitro. In the present study, the effects of inhibiting reactive oxygen species generation during a PC protocol in vivo using an open-chest porcine model were examined. Myocyte ultrastructural changes assessed by electron microscopy were correlated with phosphorus nuclear magnetic resonance spectroscopy data. Open-chest pigs underwent 60 min of left anterior descending coronary artery occlusion. PC was elicited by a single episode of 5 min occlusion and 5 min reperfusion. The cell-diffusible hydroxyl radical and superoxide radical scavenger, N-2-mercapto-propionyl glycine (MPG, 20 mg/kg), or placebo saline were infused for 40 min, starting 30 min before PC (PC plus MPG group, n=10; and PC group, n=9). After PC, ATP and intracellular pH were significantly preserved through 25 min of ischemia (control versus PC, 46+/-3% versus 55+/-5% of baseline [P<0.05]; and control versus PC, 6.18+/-0.08 versus 6.42+/-0.03 [P<0.05], respectively). Phosphocreatine was significantly preserved through 20 min of ischemia (control versus PC, 0+/-0% versus 7+/-2% of baseline [P<0.05]). The preservation of high-energy phosphate metabolites and intracellular pH was abolished by inhibiting the generation of reactive oxygen species with MPG. Preservation of high-energy phosphate metabolites with PC was associated with reduced ultrastructural damage, as seen by electron microscopy, including less myocyte swelling, myofibrillar disruption and nuclear chromatin margination. The present study demonstrates the importance of reactive oxygen species generation in mediating PC preservation of myocyte ultrastructure and high-energy phosphate metabolites during prolonged ischemia in vivo.