This paper summarizes the data concerning the role of the creatine phosphokinase system in muscle cells with main attention to the cardiac muscle. Creatine phosphokinase isoenzymes play a key role in the intracellular energy transport from mitochondria to myofibrils and other sites of energy utilization. Due to the existence of the creatine phosphate pathway for energy transport, intracellular creatine phosphate concentration is apparently an important regulatory factor for muscle contraction which influences the contractile force by determining the rate of regeneration of ATP directly available for myosin ATPase, and at the same time controls the activator calcium entry into the myoplasm across the surface membrane of the cells.

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The effect of glutamic acid on the cardiac contractile function and sources of anaerobic ATP formation in hypoxic myocardium was studied in isovolumic rat hearts. The presence of glutamic acid (5 mM) in the perfusate significantly diminished an increment in diastolic pressure caused by 60 min hypoxia, and facilitated its complete recovery during 30 min reoxygenation. This effect was combined with the maintenance of a higher ATP level during hypoxia and reoxygenation. The total content of lactate in the heart-perfusate system rose exactly as during hypoxia without glutamic acid, while pyruvate content decreased due to increased alanine formation. Restoration of tissue content of glutamate and aspartate in the presence of exogenous glutamic acid was accompanied by a more than 2-fold increase in succinate formation, the end-product of the Krebs' cycle under anaerobic conditions. The products of glutamic acid transamination with oxaloacetic acid, aspartic and alpha-ketoglutaric acids (5mM each), induced the same functional and metabolic alterations as glutamic acid. Amino-oxyacetic acid, a tramsaminase inhibitor, eliminated the effects caused by glutamic acid. Moreover, the inhibition of transamination was accompanied by a decreased succinate and alanine synthesis as well as insignificantly increased lactate formation compared to hypoxia without additives. The results suggest that the beneficial effect of glutamic acid is due to the activation of anaerobic ATP formation in the mitochondria rather than stimulation of glycolysis.