Omar MA, Fraser H, Clanachan AS. Ischemia-induced activation of AMPK does not increase glucose uptake in glycogenreplete isolated working rat hearts. Am J Physiol Heart Circ Physiol 294: H1266-H1273, 2008. First published January 4, 2008 doi:10.1152/ajpheart.01087.2007.-Alterations in myocardial glucose metabolism are a key determinant of ischemia-induced depression of left ventricular mechanical function. Since myocardial glycogen is an important source of endogenous glucose, we compared the effects of ischemia on glucose uptake and utilization in isolated working rat hearts in which glycogen content was either replete (G replete, 114 mol/g dry wt) or partially depleted (G depleted, 71 mol/g dry wt). The effects of low-flow ischemia (LFI, 0.5 ml/min) on glucose uptake, glycogen turnover (glycogenolysis and glycogen synthesis), glycolysis, adenosine 5Ј-monophosphate-activated protein kinase (AMPK) activity, and GLUT4 translocation were measured. Relative to preischemic values, LFI caused a time-dependent reduction in glycogen content in both G-replete and G-depleted groups due to an acceleration of glycogenolysis (by 12-fold and 6-fold, respectively). In G-replete hearts, LFI (15 min) decreased glucose uptake (by 59%) and did not affect GLUT4 translocation. In G-depleted hearts, LFI also decreased initially glucose uptake (by 90%) and glycogen synthesis, but after 15 min, when glycogenolysis slowed due to exhaustion of glycogen content, glucose uptake increased (by 31%) in association with an increase in GLUT4 translocation. After 60 min of LFI, glucose uptake, glycogenolysis, and glycolysis recovered to near-preischemic values in both groups. LFI increased AMPK activity in a time-dependent manner in both groups (by 6-fold and 4-fold, respectively). Thus, when glycogen stores are replete before ischemia, ischemia-induced AMPK activation is not sufficient to increase glucose uptake. Under these conditions, an acceleration of glycogen degradation provides sufficient endogenous substrate for glycolysis during ischemia. low-flow ischemia; glucose uptake; glycogen metabolism; glucose metabolism; adenosine-5Ј-monophosphate-activated protein kinase UNDER AEROBIC CONDITIONS, ϳ95% of the energy requirement of cardiac muscle is derived from the mitochondrial oxidation of fatty acids and carbohydrates, whereas the remainder is provided by glycolysis. However, during ischemia, oxygen (O 2 ) deprivation inhibits oxidative metabolism and glycolysis becomes a major source of myocardial ATP production (44). Thus myocardial carbohydrate availability and metabolism are critical determinants of ischemic injury and postischemic left ventricular (LV) mechanical function.Glucose transport, the first step of myocardial glucose utilization, involves the facilitated diffusion of glucose across the sarcolemmal membrane. The rate of glucose transport is determined by the transmembrane concentration gradient of glucose as well as the abundance and affinity of glucose transporter proteins, GLUT1 and GLUT4 (27). Following transport, gluco...