Evaluation of energy metabolism of viable myocardium in patients with ischemic cardiomyopathy

This research aimed to study the myocardial viability as a marker of a favorable postoperative outcome in patients with ischemic cardiomyopathy (ICMP) with anterior apical aneurysm. An effort was made to describe the state of a ‘viable’ myocardium according to the energy exchange (EE) of the left ventricular (LV) myocardium and the varying degrees of its contractile activity. The object of the study was the myocardium in patients with ICMP with anterior apical aneurysm. MRI study was performed in all patients to determine the kinesis; scintigraphy was used to assess perfusion of the LV walls. The enzymes activities of the main metabolic pathway of the myocardium were detected with the tetrazolium method proposed by Lojda. The evaluation of enzymatic activities was performed based on the intensity of myocardial structure staining using ImageJ software. As a result, we proposed the hypothesis that functional activity of the myocardium largely determined changes in the myocardial contractility rather than in the morphological state. Evaluation of the enzymatic activities allowed to reveal heterogeneity of cardiomyocytes (CMC) in regard to their activities of EE enzymes (lactate dehydrogenase, succinate dehydrogenase, and 3-hydroxybutyrate dehydrogenase). Therefore, in this study, CMC population with reduced contractile activity and with increased activity of 3-GBDG and LDH is considered viable myocardium.