Biochemical changes induced in the myocardial cell during cardioplegic arrest supplemented with creatine phosphate
Pastoris O, Dossena M, Vercesi L, Bruseghini M, Pagnin A, Ceriana P
Journal of cardiothoracic and vascular anesthesia · 12 citas
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Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 1991-10-01 · J Cardiothorac Vasc Anesth · vol. 5 · número 5 · págs. 475–480
- Editorial
- Elsevier BV
- Citado
- 17 citas · más que el 66% de estudios similares · 0.5× el promedio de su campo
- Referencias
- 45 trabajos
- Acceso
- De pago
- Áreas de investigación
- Cardiac and Coronary Surgery Techniques · Cardiac Ischemia and Reperfusion · Transplantation: Methods and Outcomes
- Palabras clave
- phosphocreatine, cardioplegia, cardioplegic arrest, myocardial energy metabolism, papillary muscle, mitral valve replacement, cardiopulmonary bypass, hexokinase, malate dehydrogenase, glutamate dehydrogenase, NADH-cytochrome c reductase, myocardial enzyme activity, cardioprotection
- MeSH
- myocardium, heart, mitral valve, humans, phosphocreatine, cardioplegic solutions, heart arrest, induced, heart valve prosthesis, energy metabolism, middle aged, female, male
6 autores
- Ornella Pastoris🇮🇹 · autor de correspondenciaUniversity of Pavia; Policlinico San Matteo Fondazione
- Maurizia Dossena🇮🇹University of Pavia; Policlinico San Matteo Fondazione
- Lorena Vercesi🇮🇹University of Pavia; Policlinico San Matteo Fondazione
- M. Bruseghini🇮🇹University of Pavia; Policlinico San Matteo Fondazione
- Adriano Pagnin🇮🇹University of Pavia; Policlinico San Matteo Fondazione
- Piero Ceriana🇮🇹University of Pavia; Policlinico San Matteo Fondazione
Resumen
El texto original del estudio, en el idioma en que se publicó.
The purpose of this work was to evaluate the biochemical changes in the myocardial cell using cardioplegia supplemented with creatine phosphate (CP). Many previous studies have demonstrated the beneficial effect of CP on the ischemic myocardium and its mechanism of action has been assumed to be mainly extracellular. Based on the assumption that CP could also exert some influence on myocardial cellular metabolism, this investigation was carried out. Forty patients undergoing mitral valve replacement were divided into two groups: group 1 was treated with standard cardioplegic solution, and group 2 was treated with cardioplegic solution enriched with CP at a concentration of 10 mmol/L. Samples of papillary muscle, obtained from the removed valve, were studied by means of biochemical methods in order to assess the enzyme activities and the metabolites of the different biochemical pathways related to energy metabolism in the myocardial cell. One papillary muscle sample was used to determine enzyme activities spectrophotometrically; another was used to evaluate metabolite concentrations by spectrophotometric or spectrophotofluorimetric methods. The rate of spontaneous functional recovery after rewarming and weaning from cardiopulmonary bypass (CPB) also was evaluated. In group 2, the Vmax of enzymatic activities was significantly greater (hexokinase, malate dehydrogenase, glutamate dehydrogenase, total NADH cytochrome c reductase) and a better functional state of the heart was observed after CPB. On the basis of the clinical and biochemical data, it is concluded that the myocardium was better preserved when CP was added to the cardioplegic solution. Therefore, the results suggest a possible interaction of exogenous CP with cellular metabolism.
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