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Early and late changes in the metabolic pattern of the working myocardial fibres and Purkinje fibres of the human heart under ischaemic and inflammatory conditions: An enzyme histochemical study

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Summary

In this communication, the results of an enzyme histochemical study on the working myocardial fibres and Purkinje fibres of the atrioventricular conducting system of the human heart under ischaemic and inflammatory conditions are presented. The material was selected from patients showing changes which could be classified in three major groups: (1) early changes due to acute ischaemia either in the myocardial fibres or in the conducting system or in both; (2) chronic ischaemic changes due to cardiovascular insufficiency, such as old infarction, or coronary arteriosclerosis or both; and (3) inflammatory conditions such as myocarditis.

The activity and location of about 20 enzymes that play a role in the aerobic and anaerobic pathways of energy metabolism were examined. The activity and location of some hydrolytic enzymes and the glycogen and lipid content were also studied.

The most important findings were an obvious depletion of the glycogen reserves under acute ischaemic changes in both types of fibre. This was associated with a transient or permanent reduction in activity of many enzymes that play a role in aerobic and anaerobic metabolism. Further, there was an instantaneous and persistent increase in the activity of the NADPH-regenerating enzymes of the pentose phosphate pathway and of glyceraldehyde-3-phosphate dehydrogenase, the rate-limiting enzyme of glycolysis under ischaemic conditions. Chronic ischaemic changes were characterized by a gradual long-term increase in the activity of many anaerobic glycolytic enzymes. Moreover, there was an absence of activity of acetylcholine esterase immediately after the onset of infarction in the fibres of the conducting system. Lastly, a slight increase in lipid content was found in the hypertrophic chronic ischaemic fibres and in old infarcted areas. Cardiac fibres in inflamed areas showed a marked increased activity of the pentose phosphate shunt enzymes and a less pronounced increased activity of most anaerobic and hydrolytic enzymes. In contrast to the cardiac fibres in infarcted areas, the fibres in inflamed areas did not reveal a decrease or absence of activity of aerobic enzymes such as succinate dehydrogenase.

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Authors and Affiliations

  1. Central Laboratory for Public Health, Jelsumerstraat 6, 8917 EN, Leeuwarden, The Netherlands

    E. A. Elias

  2. Department of Paediatrics, St Lucas Hospital, Gassingel 18, 9670 RA, Winschoten, The Netherlands

    R. A. Elias

  3. Laboratory of Pathological Anatomy, Histochemical and Biochemical Section, Wilhelmina Gasthuis, University of Amsterdam, Eerste Helmersstraat 104, 1054 EG, Amsterdam, The Netherlands

    G. P. De Vries & A. E. F. H. Meijer

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  1. E. A. Elias
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Elias, E.A., Elias, R.A., De Vries, G.P. et al. Early and late changes in the metabolic pattern of the working myocardial fibres and Purkinje fibres of the human heart under ischaemic and inflammatory conditions: An enzyme histochemical study. Histochem J 14, 445–459 (1982). https://doi.org/10.1007/BF01011856

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