This thesis aims at defining the relevance and
applicability of some metabolic aspects of acute
myocardial ischemia to delineate occurrence and
extent of the latter in man. Studies focus on myocardial
lactate metabolism and adenine nucleotide
catabolism, correlate changes with other markers
of ischemia and attempt to define a temporal
relation with regional changes in coronary flow.
Next, the acute antiischemic properties of different
vasoactive compounds are outlined using these
metabolites in a properly defined study model.
Studies also attempt to differentiate the usefulness
of various vasodilator compounds as antiischemic
therapy in relation to the underlying cardiac
function.
In the second part of this thesis the impact of
myocardial ischemia on systemic and cardiac neurohormones,
i.e. catecholamines and renin-angiotensin
system(s), are discussed.
The relation between degree of ischemia and neurohumoral
activation will be emphasized, potential
subsequent systemic and coronary vasoconstrictor
effects mentioned, and the usefulness of neurohumoral
modulation, i.e. by converting enzyme
inhibition in the treatment of myocardial ischemia
indicated
