Low flow after global ischemia to improve postischemic myocardial function and bioenergetics
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Updated: Sep 28, 2026
Delayed Intramyocardial Delivery of Stem Cells after Ischemia Reperfusion Injury in a Murine Model
Published on: September 3, 2020
Paul F Klawitter1, Holt N Murray, Thomas L Clanton
1Department of Emergency Medicine, The Ohio State University, Columbus, OH 43210, USA.
Objective:
In this study, we test the hypothesis that a period of low flow perfusion before full reperfusion improves ventricular function and bioenergetics.
Design:
Prospective, randomized, controlled animal study.
Setting:
Research laboratory.
Subjects:
Sprague-Dawley rats.
Interventions:
Hearts were perfused with Krebs-Henseleit buffer at 85 mm Hg. The protocol consisted of 10 mins of baseline flow, 15 mins of global ischemia, 5 mins of low flow ischemia, and 30 mins of reperfusion. Groups received 10% or 1% of baseline flow during the low flow period. A control group received 0% low flow (20 mins of global ischemia).
Measurements And Main Results:
Left ventricular function was continuously measured. Hearts were freeze-clamped at various time points, and metabolites were measured. At 10% flow, following global ischemia, both left ventricular function and bioenergetics improved compared with 0% flow and 1% flow. At 1% flow, no changes in function were seen and adenosine 5'-triphosphate concentrations decreased during reperfusion, compared with no flow (9.4 +/- 1.0 vs. 13.2 +/- 1.0 micromol/g of dry weight, p <.01).
Conclusions:
Following global ischemia but before full reperfusion, a period of low flow improves postischemic myocardial function and energetic recovery, only if a certain level of low flow is met. Very low flow may further reduce bioenergetic recovery without improvement in postischemic function, compared with continuous global ischemia.
