Glycogen. Glucose-6-Phosphate. Pyruvate. Acetyl-CoA

Transcription

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3 # 6DAE EJE= JEIIKA??A JH=JE L= KAIMAHA= HAB A?JJD IA A=IKHA@ANFAHE A J= O 6=> A 6DAKF@=JA@F=H= AJAHI=HA EIJA@E 6=> AI # 2=HJEJE? ABBE?EA JIMAHAAIJE =JA@ BH E EJE= IJK@OIJ=JAL= KAIB H=HJAHE= LA JH=JE B AJ KFJ= A HHA A=IA& 6DA =JDA =JE?= HAFHAIA J=JE EI=IAJ B@EBBAHA JE= = CA>H=E?AGK=JE IJD=JB H = E EJE= L= KAFH > A 464) JDAAGK=JE IMAHAI LA@KIE C 5,-5 = E F E?EJE JACH=J H@ALA =HID= A@AIFA?E= OB I 6DA 5,-5I BJM=HAEI=L=E => AB H@ M =@ =JDJJF MMM AJ E> HC = E= FH C B ) E = 2HAF=H=JE -NFAHE A JIMAHAFAHB H A@ $@ AIJE?FECI A= MAECDJ!% C 6DAIAIJK@EAI =?? H@=?AMEJDJDA/KE@AB B => H=J HO) E = I 10 2K> E?=JE K IJEJKJE = ) E = EJJAA=J+=IA9AIJAH 4AIAHLA7 ELAHIEJO 9AKIA@=FHALE KI O@ALA FA@ JD=J= MIB HIE K J= A KI A=IKHA A JI B O?=H@E= IK>IJH=JAKJE E =JE C K? IA =?J=JA AJ=> EJA??A JH=JE IE =HJAHE= H =HOLA JH=JE I #. ME C= LAH ECDJB=IJ = E = IMAHAIA@=JA@MEJD$ C C B6A = E CELA EI B KH= A#>O KJD Glycogen Glucose Glucose-6-Phosphate O 2 ATP ADP NAD + ADP Lactate NADH ATP Pyruvate NADH NAD + ETC ATP ADP NAD + H 2 O NADH Fatty Acid Acetyl-CoA ATP PC NAD + ADP Cr NADH CO 2.ECKHA 5?DA =JE?@AFE?JE BJDA AJ=> E?HA=?JE IE? HF H=JA@E JDA? FKJ=JE

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5 #! 6=> A! 1 EJE=. KNAI CMAJMJ E. KN. KN8= KA 4ABAHA?A φ / /2 " ' φ.) 6/ $!" φ.) )+ " φ /2 2; " ' φ /2 /; ' φ /; /2 ' φ 6/.)!" φ 2; ) $ φ 2; )+ %! φ ) 2; # φ )+ + $ φ 0 & φ φ φ )+ + )2! φ + )2.+! φ )62DO@H OIEI %!,A JAI@=J=BH FHAIA JIJK@O 6=> A" 8= KAI CMAJMJ / /2 #.) 6/ "#.) )+ "# /2 2; /2 /; /; /2 6/.) % %!!! " 2; ) 2; )+ ) 2; )+ +! && "$ )+ + )2 + )2.+ && && "$ "! LE=JDAANJH=? F H= FAHBKIE?EH?KEJ 6DAB MM=I=@ KIJA@J CELA= E JAHLA JHE?K =HLA KI DA C >E I=JKH=JE B!# "" $ % )HJAHE= F AIMAHA >J=E A@BH JDA FAHBKIE E KII= F AIBH JDA= JAHE HE JAHLA JHE?K =HLAE 6DAEI J FE?JH=?AHI " + C K? IA! + =?J=JA! 0 A=JA DAF=HE O?AHE@AA K IE MAHAE BKIA@E J =BA H= LAE 0A=HJH=JA = HJE?FHAIIKHA ABJLA JHE?K =HFHAIIKHA E?JDE? A E CMAHA? JE K KI O HA? H@A@KIE C E A@=J==?GKEIEJE I BJM=HA*E 2=?)? M A@CA ABJLA JHE?K =H? JH=?JE A BK?JE M=I EJ HA@>O A=IKHE C ABJLA JHE?K =HFHAIIKHAMEJD=%.H E =H E H JEF JH= JAHE HM= ID HJA E CKIE CI E E?H AJAH?HOIJ= I6HEJ 6A?D CEAI 5=,EAC +)F =?A@E JDA E@ O?=H@EK $ &

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

7 # # 120 STEP PROTOCOL LAD Blood Flow (% of normal control flow) Time (min) RAMP PROTOCOL LAD Blood Flow (% of normal control flow) Time (min).eckha 5JK@OFH J? I )2H J? B HIJAF HA@K?JE E B M * 2H J? B HH= FHA@K?JE E M =I = I= F AI + LE= I I=JKH=JA@I= E?O E?=?E@ 55)I= F AIMAHA? A?JA@=JIEN@EBBAHA J F AJE AF E JI " + C K? IA " + =?J=JA??A JH=JE IMAHAE A@E=JA O@AFH JAE E A@E FAH?D HE?=?E@ L L 6DAOMAHAJDA = = O A@B HC K? =?J=JAKIE CA O =JE? IFA?JH FD J AJHE?=II=OI! # 6DAIFA?EBE?H=@E =?JELEJO B " + C K? IAM=I JAE E F AIKIE CE AN?D= CAHAIE?DH " +??A JH=JE M=I=IIAIIA@>OJH=FFE CEJE DO= E ADO@H NE@A =IFHALE KI O@AI?HE>A@' 2 =I 0 A=JA??A JH=JE IMAHA A=IKHA@=IFHALE KI O@AI?HE>A@!! 0 M=I A=IKHA@>O@AJAH E E BM=JAH@EIJE A@BH F =I =KIE C =0E? = IJE JAI/ =II +KIJ 5D F " 6DAA HE?D A J B =?J=JAMEJD! + =?J=JAM=I A=IKHA@E F =I =@AFH JAE E A@MEJDI= E?O E?=?E@KIE C/+ 5= = OIEI BJDAJAHJ AJDO IE O 6*, 5@AHEL=JELA=IFHALE KI O@AI?HE>A@ #

8 # $ 6DAJEIIKA>E FIEAIJ= CJDAE EJE= E # E E BJDA$ HA@K?JE E B MMAHAKIA@J A=IKHAJDAJEIIKA ALA I B)62 ),2 C O? CA =?J=JA 6EIIKA ALA I A=IKHA@ K E AJHE?= O>O KI O@AI?HE>A@ $ 6EIIKAC O? CA M=I A=IKHA@MEJDFAH?D HE?=?E@ANJH=?JIKIE CJDA= O C K? IE@=IA KI O@AI?HE>A@ % 6EIIKA =?J=JA A=IKHA A JIMAHA? F AJA@MEJD= A O =JE? IFA?JH B K H AJHE?=II=O KIE EGKAIE E =HJ JD=J =?J=JA=II=O 6DA! CH= FK?D>E FIOJ= A =JJDA?? KIE BA=?DANFAHE A JM=IKIA@J A=IKHA ), JHEC O?AHE@A ALA I 6EIIKAM=IANJH=?JA@E H B H AJD= L L JHEC O?AHE@A ALA IMAHA A=IKHA@KIE C= A O =JE?IFA?JH FD J AJHE?=II=O6HEC O?AHE@A- EJ 9= +DA E?= I 8) ), M=I A=IKHA@IFA?JH FD J AJHE?= OKIE C=FHALE KI & +=?K =JE I 6DA AJKFJ= AI CMAJMAECDJ E B HC K? IA =?J=JA =JA@>=IA@ BJDA=HJAHE= H =HOLA H = E A@ O?=H@E= M CMAJMAECDJ E 6DAH=JAI BAN CA KIC K? B=JJO=?E@ NE@=JE MAHA?=?K BJDAHA A=IA BAEJDAH " + H! H = E A@ O?=H@E= IFA?EBE?H=@E =?JELEJO BC K? IA H BHAAB=JJO=?E@I@F! 5E K J= A KI =?J=JAKFJ= A=IAMAHA?=?K =JA@BH JDA! + =?J=JAA HE?D =?J=JA??A JH=JE I=IFHALE KI O@AI?HE>A@ 6DAH=JAI BC K? NE@=JE B MAHA E E CJDAE EJE= B KNL= KAI6=> A! O?=H@E= MM=I A=IKHA@BH JDA?= E>H=JA@FK FB M H = E A@>O@ELE@E C>OJDAMAECDJ BJDADA=HJ >AE CFAHBKIA@>OJDA ),% 6DA 82 IAC A J A CJD F=HA=M=I?=?K =JA@ BB E ABH =FFH NE =JA O!? IA?KJELA DA=HJ>A=JI>OKIE CI BJM=HA@ALA FA@E =J => 6DEIM=IKIA@=I= BJDAANJAH = M H BJDA= JAHE HBHAAM= BJDA ABJLA JHE? BJDAE EJE= IJ=JA L= KAI 6DA 82 IAC A J A CJD F=HA= K JEF EA@>OJDADA=HJH=JAM=IKIA@=I= BJDA ANJAH = F MAH BJDA= JAHE HM= 5J=JEIJE?= ) = OIEI 6HEC O?AHE@A ),??A JH=JE IMAHA? F=HA@>AJMAA JDA B AN+.:? JH FCH KFIKIE C=JM M=O= = OIEI BL=HE=?A 7FJ= AI B C K? IA =?J=JA = = E?F=H= AJAHI HACE = = JAHE HM= M H F O? CA JH=JE MAHA? F=HA@KIE C=JM M=OHAFA=JA@ A=IKHA= = OIEI BL=HE=?A KIE C=5JK@A J AM = AK IJAIJB HF IJD?? F=HEI I ) JAIJIB HIEC EBE?=?AMAHAFAHB H A@=JJDA # ALA BIEC L= KAI=HAHAF HJA@=I A= I E K =JE 4AIK A J=,=J= 4= FEI?DA CB MBH J " %$ " C E J! C E B H =? H ME = E A=H = AH LAH! E MDE AIJAFEI?DA CJDA

9 # % B MJDAI= A =C EJK@A %! # C E J ' C E LAH E 6 JAIJJDAH >KIJ AII B KH? FKJ=JE MEJDKF@=JA@ E AJAHL= KAI MA? F=HA@JDA??A JH=JE B KNH=JAIJD=JMAHA A=IKHA@ANFAHE A J= OMEJDJDA? IE K =JA@HAIK JI 9EJDJDAE BEI?DA E= JDAHAM=I= E A@E=JA@A?HA=IAE O?=H@E= NOCA? IK FJE F HJE )62.ECKHA!* IE K =JE IB H> F ID M=#@A?HA=IAE 8 MDE AANFAHE A J= OJDA@A?HA=IAIMAHA#" HAIFA?JELA O6=> A$ 6DAIAHAIK JIID JB MHA@K?JE FH BE AIHAIK JE IE E =HIJA=@O IJ=JA@A?HA=IAIE 8 6DA@A?HA=IAIE )62B HANFAHE A J= IE K =JA@ HAIFA?JELA O MDE AJD IAB HH= FEI?DA 6=> A$ = E?L= KAIBH E LEL IME AANFAHE A JI Ramp Reduction in Blood Flow 60% Reduction in Blood Flow HR (beats/ min) Baseline Step 111 ± ± ± ± 6.3 Ramp 115 ± ± ± ± ± ± 9.4 Peak LVP (mm Hg) Step 88 ± ± 4.7* 80 ± 5.2* 79 ± 4.1* Ramp 87 ± ± ± ± 5.4* 79 ± 5.2* 75 ± 3.5* dp/dt max (mm Hg/s) Step 2341 ± ± ± ± 175 Ramp 2503 ± ± ± ± ± ± 149 dp/dt min (mm Hg/s) Step ± ± ± ± 141 Ramp ± ± ± ± ± ± 73 MVO 2 (µmol/g/min) Step 2.43 ± ± 0.08* 0.95 ± 0.09* 0.88 ± 0.06* Ramp 2.75 ± ± ± ± 0.09* 1.09 ± 0.13* 1.03 ± 0.09* Work (mm Hg mm) Step ± ± ± 0.12* Ramp ± ± ± ± ± 0.12* Power (mm Hg mm/s) Step ± ± ± 0.15 Ramp ± ± ± ± ± = KAI=HA A= I 5-MEJD%FECIE JDAH= FCH JDAIJAFCH KF BEHIJ@AHEL=JELA BFHAIIKHA 82 ABJLA JHE?K =HFHAIIKHA 8 O?=H@E=? IK FJE 9 H MAH=HAANFHAIIA@=IJDABH=?JE BJDA>=IA E AL= KA 2 #? F=HA@J >=IA E A

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