Key result
During total ischemia in vitro, the subendocardium showed accelerated ATP depletion compared with the subepicardium (p<0.05), indicating cell death begins in the subendocardium independent of wall tension.
Population
10 left ventricular globally ischemic slabs (in vitro model)
Comparison
Total ischemia in vitro vs Subepicardium (compared to subendocardium)
Design
Preclinical
Authors
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Highlights metabolic drivers of subendocardial vulnerability; leaves open clinical translation pending in vivo studies.
p-value: p=<0.05
Ischemic cell death begins in the subendocardium independent of collateral flow or wall tension, likely due to an inherently increased metabolic rate resulting in faster ATP use.
Lowe et al. (1983) studied Myocardial ischemia (n=10). Subendocardium location during total ischemia vs. Subepicardium was evaluated on Gradient of ATP depletion and ultrastructural evidence of irreversible injury (p=<0.05). During total ischemia in vitro, the subendocardium showed accelerated ATP depletion compared with the subepicardium (p<0.05), indicating cell death begins in the subendocardium independent of wall tension.
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