Background-Our objective for this study was to investigate whether nitric oxide (NO) modulates tissue respiration in the failing human myocardium. Methods and Results-Left ventricular free wall and right ventricular tissue samples were taken from 14 failing explanted human hearts at the time of transplantation. Tissue oxygen consumption was measured with a Clark-type oxygen electrode in an airtight stirred bath containing Krebs solution buffered with HEPES at 37°C (pH 7.4). Rate of decrease in oxygen concentration was expressed as a percentage of the baseline, and results of the highest dose are indicated. Bradykinin (10 Ϫ4 mol/L, Ϫ21Ϯ5%), amlodipine (10 Ϫ5 mol/L, Ϫ14Ϯ5%), the ACE inhibitor ramiprilat (10 Ϫ4 mol/L, Ϫ21Ϯ2%), and the neutral endopeptidase inhibitor thiorphan (10 Ϫ4 mol/L, Ϫ16Ϯ5%) all caused concentrationdependent decreases in tissue oxygen consumption. Responses to bradykinin (Ϫ2Ϯ6%), amlodipine (Ϫ2Ϯ4%), ramiprilat (Ϫ5Ϯ6%), and thiorphan (Ϫ4Ϯ7%) were significantly attenuated after NO synthase blockade with N-nitro-L-arginine methyl ester (10 Ϫ4 mol/L; all PϽ0.05). Ϫ4 mol/L, Ϫ34Ϯ5%) and nitroglycerin (10 Ϫ4 mol/L, Ϫ21Ϯ5%), also decreased tissue oxygen consumption in a concentration-dependent manner. However, the reduction in tissue oxygen consumption in response to S-nitroso-Nacetyl-penicillamine (Ϫ35Ϯ7%) or nitroglycerin (Ϫ16Ϯ5%) was not significantly affected by N-nitro-L-arginine methyl ester.
Conclusions-These results indicate that the modulation of oxygen consumption by both endogenous and exogenous NOis preserved in the failing human myocardium and that the inhibition of kinin degradation plays an important role in the regulation of mitochondrial respiration. (Circulation. 1999;100:1291-1297.)Key Words: nitric oxide Ⅲ oxygen Ⅲ heart failure T he vast amount of ATP produced by the cardiac mitochondria is used mainly for cardiac muscle contraction. Abnormalities of mitochondria in cardiomyocytes in heart failure have been well documented in both animals [1][2][3][4] and human studies, 5-7 which provided structural and metabolic evidence of mitochondrial dysfunction. Mitochondrial DNA damage with increased mitochondrial DNA deletion in patients with heart failure has also been reported, 8,9 a defect associated with the impairment of oxidative phosphorylation. 10 On the other hand, normal mitochondrial metabolism has also been documented in chronic heart failure. 11,12 However, the role of nitric oxide (NO) in the control of mitochondrial metabolism is not well established. Our laboratory and others have demonstrated that attenuation of NO production increases whole-body or organ oxygen consumption. [13][14][15][16] The initial observation of the interaction between NO and mitochondrial enzymes was reported in cell culture studies of macrophage-induced cytotoxicity of neoplastic cells. 17,18 The activated macrophage induced reduction of electron transfer by inactivating iron-sulfur-containing complexes I and II of the respiratory chain and aconitase in the Krebs cycle. This effect was shown to b...