Isolated, paced, isovolumetrically beating piglet hearts ( n = 37) underwent retrograde aortic perfusion with a crystalloid solution during three periods: 1) baseline (coronary perfusion pressure 60 mm Hg), 2) ischemia (coronary flow 10% of baseline for -80 min), and 3) reperfusion (perfusion pressure returned to baseline). In one group of hearts, glycolysis (using "H,o formation from [3H]glucose) was assessed. During baseline, peak systolic pressure (PSP) was 101.1 i 5.0 mm Hg, end diastolic pressure (EDP) 4.4 z 0.5 mm Hg, glycolysis 970.5 -C 65.3 nmol/min/g,,,, and myocardial glycogen 234.8 2 12.0 pmoll g,,,. During ischemia, PSI' decreased to 23.3 t 2.7 mm Hg, BDP increased to 12.3 2 0.7 mm Hg, myocardial glycogen decreased to 181.5 2 30.3 pmol/g,,,, and lactate (-154 pmoll g,,,) and glycerol (-930 nmol/g,,,) were released. Myocardial contracture correlated with a decrease in lactate release. Glycolysis decreased to -400 nmol/min/g,,, and remained stable, accounting for =SO% of the lactate producetl. During reperfusion, PSP recovered to 79.8 2 3.5 mm llg, EDP 6.6 2 1.7 mm Hg, and glycolysis 1103.9 + 81 nmol/rnin/g,,,. In a second group of hearts, with similar mechanical responses, giucose oxidation (using "CO, formation from ['4C]glucose) was evaluated. During baseline, glucose oxidation was 165.4 -t 15.9 nmol/min/g,,, and correlated closely (r = 0.957) with rnechanical activity. With ischemia, glucose oxidation decreased to =17Myocardial contracture represents a state of decreased diastolic compliance of the ventricle secondary to a depletion of high energy stores in the region of the contractile apparatus (1).With ischemia, contracture occurs as a consequence of myocardial underperfusion, which results in inadequate substrate delivery and impaired ATP production. Insufficient ATP leads to a progressive increase in the number of myocin-actin complexes that are unable to dissociate and to derangements in resting cytosolic calcium levels (2). (3,4). Little is known about myocardial contracture in the setting of low-flow ischemia, where hearts are beating, and there is washout of metabolites. Additionally, the modalities of energy production and utilization associated with contracture are poorly understood, yet these processes ultimately determine myocardial viability. An understanding of these processes in neonatal hearts has significant clinical ramifications, because contracture is thought to represent a precursor to an irreversible myocardial injury (5).The objectives of the present investigation were to study myocardial contracture in isolated, isovolumetrically beating, neonatal pig hearts subjected to normothermic, low-flow isch-