[Physiopathologic modifications in the myocardial levels of adenine nucleotides]

When the equilibrium between energy production and utilization is disrupted in the myocardium, the metabolism of adenine nucleotides is greatly altered. The first alteration is a change in the degree of phosphorylation which induces alterations in the respective amounts of AMP, ADP and ATP. This change, in turn, creates an imbalance between synthesis and degradation of adenine nucleotides. As a consequence, the levels of AMP, ADP and ATP are not restored when physiological conditions are reestablished. The aim of this paper is to describe the alterations of adenine nucleotides which occur in physiopathological conditions (ischemia, hypertrophy) and to discuss the use of the levels of AMP, ADP and ATP as indicators of the metabolic state of the heart. Brief descriptions of the methods used for determinations of concentrations and of the processes of energy transfer and adenine nucleotide synthesis in the myocardium are given.