Open Access e-Journal Cardiometry No.16 May 2020
We should mention that Cardiometry is a fine diagnostics tool to assess heart life expectancy. Our experts, using Cardiocode in “red zones” in intensive care units, have confirmed effectiveness of noninvasive measuring of the hemodynamics data on the cardiovascular system performance in critical patients with different severity degrees. The medical staff involved had a possibility not only to monitor the state in each critical patient, but also to predict and control the progression of a disease. We are going to publish some results of this pilot study in our next issues. We should mention that Cardiometry is a fine diagnostics tool to assess heart life expectancy. Our experts, using Cardiocode in “red zones” in intensive care units, have confirmed effectiveness of noninvasive measuring of the hemodynamics data on the cardiovascular system performance in critical patients with different severity degrees. The medical staff involved had a possibility not only to monitor the state in each critical patient, but also to predict and control the progression of a disease. We are going to publish some results of this pilot study in our next issues.
Succinic acid as an intermediate in theenergy exchangeWithin the Krebs cycle, succinic acid (SA or succinate)is produced as a result from the oxidative decarboxylationof α-ketoglutarate and the progress of thesuccinate tyokinase reaction. The next step is whenSA (succinate) is oxidized to fumarate by succinatedehydrogenase (SDH), which is not only a ferment inthe TCA cycle, but also complex II in the respiratorychain of the mithochondria. The papers by Chance B.[19], Kondrashova M.N. [20, 21, 22] and some otherresearchers have demonstrated that there is a uniquelyhigh power output produced by mithochondria due tosuccinate oxidation. The process of the succinate oxidationoutperforms all intermediates found in the energyexchange for the oxygen consumption rates andthe ATP synthesis, value of the transmembrane electrochemicalpotential of hydrogen ions ΔμН + , generatedon the inner membrane of mithochondria, as wellas for the capability to maintain energy-dependentprocesses like reverse electron transfer (RET) or accumulationof the Са 2+ ions. The succinate oxidation resultsin a release per time unit of much greater energyequivalents than it is the case with the oxidation of anyother substrate in the TCA cycle or any fat acids in theβ-oxidation reactions.M.N.Kondrashova and her Scientific School havepresented their own concept of a special role of thesuccinate oxidation in mithochondria in energy supplyrequired for the functioning cycle “rest – performance– recovery” [20, 21, 22]. This concept hasplayed a leading role in the proper understanding ofthe fact that a high energy power due to the succinateoxidation is a prerequisite for a success in the use ofSBC under high energy consumption conditions, orenergy deficit and acidosis, under adaptation to heavyloads and post-loading recovery [23].Anti-hypoxia effect produced bysuccinate-based compositionsThe most vivid example to illustrate the succinicoxidation and formation features can be found underhypoxia. Acute hypoxia ranging up to anoxia is attributedto most functional loading cases and shouldbe considered to be at the root of many adaptive andpathological states. It should be remembered that evenunder normoxia there can be detected some hypoxia-affectedareas, which may appear due to heterogeneityin oxygen supply of different areas in tissues,cells and mithochondria [24, 25]. Tissue heterogeneityin the рО2 distribution can be explained by differentlengths of the diffusion path used to transportoxygen to the cells located at different distances fromthe respective blood vessels. And in addition, it is wellknown that at rest not all of the capillaries are involvedin the operation. Therefore, the farthest cells, whichare located at the greatest distances from the arteriolesand the artery part of the capillary net, are affected byhypoxia. The same is applicable to the mithochondrialocated at the greatest distances from the cell surface.Under a considerable surge in the tissue functionalactivity, there is mismanagement or discord betweena relatively slow and/or deficient mobilization of theblood circulation system plus oxygen transport, on theone hand, and a very fast transition of the cells and tissuesfrom their rest to their activity, on the other hand.The most pronounced disagreements in the energydemands can be established between the cells beingat rest and those being active in the excitable tissues,which are found in our heart, skeletal muscles and ofcourse our nervous system. Energy expenditures requiredby the excitable tissues may rapidly grow by afactor of ten and over. As a consequence, the amountof the tissue рО2 decreases, the number of hypoxia-affectedareas rises and some temporarily availablezones of anoxia appear. In our further considerations,we dwell on differences in conversions of SA in theTCA cycle under the hypoxia and anoxia or anaerobiosisconditions.Due to high affinity of citochrome oxidase for oxygen,the transport of the reductive equivalents and theoxidative phosphorylation in the respiratory chain ismaintained even under deep hypoxia. Lowering oxygenconcentrations up to 04,-0,7 µM does not stopfunctioning of complexes II, III and IV [26, 27]. Butit has been revealed that the redox state of respiratorycarriers and cytochrome oxidase in tissues aremore sensitive to a decrease in рО2 [27, 28] as it isthe case in vitro. In particular, for the first 5 secondsunder heavy hypoxia (with an oxygen concentration ata level of 20 µM), in isolated tissue sections, pyridinenucleotides are much greater reduced than the othertransporters in the respiratory chain [28]. The samedifferences have been reported for a perfused organduring the transition from normoxia to anoxia [29]:in the hypoxic transition state, practically full reductionof pyridine nucleotides has been observed with asufficiently high degree of the oxidization of flavopro-16 | Cardiometry | Issue 16. May 2020
teides. As a rule, under the hypoxic conditions, the oxidationof the NAD-dependent substrates is disrupted,the NADН/NAD ratio significantly grows, andsome preconditions for the prioritized oxidation ofsuccinate are generated [30]. It has been detected thatcomplex I is highly sensitive to actions of a great varietyof damaging factors and inhibitors, representedby different lipophylic compounds [31, 32]. Besides, ithas been established that complex I can lose its prostheticflavine mononucleotide group [33,34]. Due toan effect of increased concentrations of the nitrogenmonoxide and other nitrolyzing compounds, formedin the cell under oxygen deficiency conditions, complexI leaves its active state A for its inhibited state D[35]. Barbiturates, acetaldehyde and rotenone reproducethis situation and make it possible to simulate itin vitro with the total inhibition of complex I and consumptionof oxygen in the oxidation of NAD-dependentsubstrates, for example, β-oxybutirate (see Figure1 herein). It has turned out that of great importanceare the presence of electronophylic metabolites likeoxaloacetate and the progress of the fumarate reductasereaction that promotes the succinate formation bythe reductive conversion in the Krebs cycle. Owing tofunctioning of complexes II, III and IV [26, 27, 36],succinate produced due to a high level of NADH is immediatelyoxidized (see Figure 1A herein). Malonateas the SDH inhibitor stops both the succinate oxidationand the fumarate reductase reaction. Accordingto recorded data on the malonate-sensitive oxygenconsumption in the presence of rotenone and by generationof transmembrane potential ΔΨ (see Figure1 Вherein), we can estimate dynamically the contributionof the NAD-dependent substrates, for instanceof α-ketoglutarate or some mixtures of substrates likeα-ketoglutarate with aspartate, or malate with pyruvateetc., to the succinate formation.The prioritized oxidation of succinate under hypoxia(against the background of a high degree of theNADH reduction) is provided by the availability of theoxidized flavoproteides and coenzyme Q and a flowof the reductive equivalents at the terminal portion ofthe respiratory chain. It is interesting that even undernormoxia (really under hyperoxia in the incubationcuvette) in state 4 according to B. Chance and G.R.Williams [36], due to an increase in the degree of theNADH reduction, observed is the prevailed oxidationof succinate that is recorded by loss of radioactivity ofa radioactive tracer in vitro in the intact rabbit’s heartA [O 2]RLMng-AtB200mV100mV05004003002001000ΔΨTPP +0TPP +β-OB DNPTPP +RLM+ NADsubstrate60 120 180 240 srotenonerotenoneα -KGSuccinateMalonateSuccinate-KG+ASPMalate + Pyr.-KG+NH4Cl1 min-OBFigure 1. Addition of rotenone into suspension of respiratingmithochondria suppresses oxygen consumption (А) in the oxidationof β-oxybutirate (β-ОВ). By adding α-ketoglutarate (α-KG) we can easily restore the respiration of mithochondria inthe liver (RLM under uncoupling of the oxidative phosphorylationby 2-4-dinitrophenol (DNP). Generation of the transmembranepotential takes place despite the fact that there isrotenone block (B) in the presence of α-ketoglutarate (α-KG)with aspartate (ASP), malate with pyruvate or α-ketoglutaratewith ammonia. The proper full-scale transmembrane potentialis generated under the oxidation of the added succinate. Theincubating medium has been composed as follows: 250 mМsucrose, 10 mM tris-HCl (pH 7,4), 10 mМ KCl, 3 mМ MgCl2, and3 mМ KH2PO4. Concentration of mithochondria is 3 mg perml; t 26°С. All substrates have been added with a final concentrationof 5 mM. DNP – 30 µmol, rotenone -10 µmol. Oxygenconsumption data have been recorded with polarography. Thetransmembrane potential has been measured with the use ofthe selective electrode according to changes in concentrationsof the lipophyl cation of tetraphynilphosphonium (TPP+).ααβIssue 16. May 2020 | Cardiometry | 17
- Page 1 and 2: 124 | Cardiometry | Issue 16. May 2
- Page 3 and 4: Dear Reader!Our life dictates what
- Page 5 and 6: Prof. Mohammad AleemCairo Universit
- Page 7 and 8: 74808597The study of hemodynamics i
- Page 9 and 10: We commemorate great Russian scient
- Page 11 and 12: and, in particular, activated is th
- Page 13 and 14: decline in the rate of those who fo
- Page 15 and 16: Table 1.Mass parameters of some org
- Page 17: REVIEW Submitted: 20.02.2020; Accep
- Page 21 and 22: Table 1Changes in ratios between th
- Page 23 and 24: Consequences of anaerobic formation
- Page 25 and 26: receptor SUCNR1 [72], which is call
- Page 27 and 28: acid and oxalacetic acid. J. Biol.
- Page 29 and 30: Issue 16. May 2020 | Cardiometry |
- Page 31 and 32: 12], we may assume that PC-assisted
- Page 33 and 34: Figure 2. Demonstration of the para
- Page 35 and 36: of doubts has been expressed by tho
- Page 37 and 38: ORIGINAL RESEARCH Submitted: 2.04.2
- Page 39 and 40: Table 2. Dependence of SHD profile
- Page 41 and 42: Figure 4Figure 5Figure 6 Figure 7Ta
- Page 43 and 44: The mapping between the SHD profile
- Page 45 and 46: Issue 16. May 2020 | Cardiometry |
- Page 47 and 48: measurement thereof cannot detect a
- Page 49 and 50: AimsThe aim of this study is to ass
- Page 51 and 52: vascular system condition, using an
- Page 53 and 54: 4. Papers devoted to the AH treatme
- Page 55 and 56: 2019;2(12):18-23. https://doi.org/1
- Page 57 and 58: ORIGINAL RESEARCH Submitted: 17.01.
- Page 59 and 60: The statistical analysis of the obt
- Page 61 and 62: Table 7Eigenvalues and percentage o
- Page 63 and 64: but also as a means for active mode
- Page 65 and 66: values [6]. Both groups are homogen
- Page 67 and 68: Table 2No. of ind.BMIAge, yearsHb,
teides. As a rule, under the hypoxic conditions, the oxidation
of the NAD-dependent substrates is disrupted,
the NADН/NAD ratio significantly grows, and
some preconditions for the prioritized oxidation of
succinate are generated [30]. It has been detected that
complex I is highly sensitive to actions of a great variety
of damaging factors and inhibitors, represented
by different lipophylic compounds [31, 32]. Besides, it
has been established that complex I can lose its prosthetic
flavine mononucleotide group [33,34]. Due to
an effect of increased concentrations of the nitrogen
monoxide and other nitrolyzing compounds, formed
in the cell under oxygen deficiency conditions, complex
I leaves its active state A for its inhibited state D
[35]. Barbiturates, acetaldehyde and rotenone reproduce
this situation and make it possible to simulate it
in vitro with the total inhibition of complex I and consumption
of oxygen in the oxidation of NAD-dependent
substrates, for example, β-oxybutirate (see Figure
1 herein). It has turned out that of great importance
are the presence of electronophylic metabolites like
oxaloacetate and the progress of the fumarate reductase
reaction that promotes the succinate formation by
the reductive conversion in the Krebs cycle. Owing to
functioning of complexes II, III and IV [26, 27, 36],
succinate produced due to a high level of NADH is immediately
oxidized (see Figure 1A herein). Malonate
as the SDH inhibitor stops both the succinate oxidation
and the fumarate reductase reaction. According
to recorded data on the malonate-sensitive oxygen
consumption in the presence of rotenone and by generation
of transmembrane potential ΔΨ (see Figure1 В
herein), we can estimate dynamically the contribution
of the NAD-dependent substrates, for instance
of α-ketoglutarate or some mixtures of substrates like
α-ketoglutarate with aspartate, or malate with pyruvate
etc., to the succinate formation.
The prioritized oxidation of succinate under hypoxia
(against the background of a high degree of the
NADH reduction) is provided by the availability of the
oxidized flavoproteides and coenzyme Q and a flow
of the reductive equivalents at the terminal portion of
the respiratory chain. It is interesting that even under
normoxia (really under hyperoxia in the incubation
cuvette) in state 4 according to B. Chance and G.R.
Williams [36], due to an increase in the degree of the
NADH reduction, observed is the prevailed oxidation
of succinate that is recorded by loss of radioactivity of
a radioactive tracer in vitro in the intact rabbit’s heart
A [O 2]
RLM
ng-At
B
200
mV
100
mV
0
500
400
300
200
100
0
ΔΨ
TPP +
0
TPP +
β-OB DNP
TPP +
RLM
+ NAD
substrate
60 120 180 240 s
rotenone
rotenone
α -KG
Succinate
Malonate
Succinate
-KG+ASP
Malate + Pyr.
-KG+NH4Cl
1 min
-OB
Figure 1. Addition of rotenone into suspension of respirating
mithochondria suppresses oxygen consumption (А) in the oxidation
of β-oxybutirate (β-ОВ). By adding α-ketoglutarate (α-
KG) we can easily restore the respiration of mithochondria in
the liver (RLM under uncoupling of the oxidative phosphorylation
by 2-4-dinitrophenol (DNP). Generation of the transmembrane
potential takes place despite the fact that there is
rotenone block (B) in the presence of α-ketoglutarate (α-KG)
with aspartate (ASP), malate with pyruvate or α-ketoglutarate
with ammonia. The proper full-scale transmembrane potential
is generated under the oxidation of the added succinate. The
incubating medium has been composed as follows: 250 mМ
sucrose, 10 mM tris-HCl (pH 7,4), 10 mМ KCl, 3 mМ MgCl2, and
3 mМ KH2PO4. Concentration of mithochondria is 3 mg per
ml; t 26°С. All substrates have been added with a final concentration
of 5 mM. DNP – 30 µmol, rotenone -10 µmol. Oxygen
consumption data have been recorded with polarography. The
transmembrane potential has been measured with the use of
the selective electrode according to changes in concentrations
of the lipophyl cation of tetraphynilphosphonium (TPP+).
α
α
β
Issue 16. May 2020 | Cardiometry | 17