J.M.M.) 20 21 22 2 23 Abstract 24 Stored muscle carbohydrate supply and energetic efficiency constrain muscle functional 25 capacity during exercise and are influenced by common physiological variables (e.g. age,26 diet, and physical activity level). Whether these constraints affect overall functional 27 capacity or the timing of muscle energetic failure during acute ischemia is not known. We 28 interrogated skeletal muscle contractile properties in two anatomically distinct hindlimb 29 muscles that have well characterized differences in energetic efficiency (locomotory-30 extensor digitorum longus (EDL) and postural-soleus muscles) under conditions of 31 reduced carbohydrate supply. 180 mins of acute ischemia resulted in complete energetic 32 failure in all muscles tested, indicated by: loss of force production, substantial reductions 33 in total adenosine nucleotide pool intermediates, and increased adenosine nucleotide 34 degradation product -inosine monophosphate (IMP). These changes occurred in the 35 absence of apparent myofiber structural damage assessed histologically by both 36 transverse section and whole mount. Restriction of the available intracellular carbohydrate 37 pool by fasting (~50% decrease in skeletal muscle) did not significantly alter the timing to 38 muscle functional impairment or affect the overall force/work capacities of either muscle 39 type. Fasting did cause rapid development of passive tension in both muscle types, which 40 may have implications for optimal timing of reperfusion or administration of precision 41 therapeutics. 42 43 44 45 46 47 48 49 Introduction 50 Ischemic skeletal muscle necrosis occurs concurrently with several common clinical 51 conditions (e.g. peripheral arterial disease, compartment syndrome, or diabetic necrosis)52 and is a complicating factor of successful muscle graft transplantation(1-3). The severity 53 of necrosis during an ischemic episode has long been considered a sole function of time, 54 temperature, and magnitude of the hypoxic insult(4,5). However, the timing of the events 55 that precede irreversible functional impairment and necrosis during ischemia may also 56 depend on other key variables including: metabolic rate; contractile efficiency; and the size 57 of the stored carbohydrate pool(4). Carbohydrate metabolism is key, as muscle energy 58 supply becomes dependent on anaerobic fermentation of stored carbohydrate sources 59 during ischemia(6-8). Glycogen is the primary storage form of carbohydrate in skeletal 60 muscle, and its storage/utilization can be influenced by acute environmental factors as 61 well as chronic diseases(9-14).
6263 Previous studies have examined the time dependent changes of metabolites and 64 contractile function in rodent skeletal muscle following ischemia with reperfusion (I/R)(15-65 18). Several important observations can be gleaned from these studies: First, locomotory 66 (fast glycolytic) muscles experienced more damage compared to postural (slow oxidative) 67 muscles(15,17). Second, The degree of initial injury ...