Insitu Monitoring Of Myocardial-Metabolism By Laser Fluorimetry - Relevance Of A Test Of Local Ischemia

We have developed a hypoxia test by local ischemia, to be performed with a special probe adapted to an in situ NADH laser fluorimeter. Local ischemia is produced by pressurization on the organ surface in an area of approximately 0.2 mm2. In order to assess the method on open-chest rat hearts (ten), we used the following protocol: local ischemia tests (three), global anoxia (100% N2 ventilation), superimposition of local ischemia to global anoxia, and local ischemia tests during the period just prior to death and immediately thereafter. Three different responses were observed: large amplitude of compensated fluorescence (Fo) increase, medium amplitude of Fo increase, and no Fo increase. These responses were related to the metabolic state prior to the test (States 3, 4, and 5 of Chance's nomenclature). We have thus demonstrated the possibility of very rapidly determining the in situ NADH degree of reduction, without a destructive assay. Such a parameter may be of great relevance in heart surgery, as it might allow detection of potentially harmful situations, thereby enabling early and appropriate treatment.