Protective effect of exogenous fructose-1,6-diphosphate in cardiogenic shock

The effect of intravenous fructose-1,6-diphosphate (FDP) infusion on haemodynamic and biochemical variables was studied in dogs after ligation of the anterior descending branch of the left coronary artery. In the control series cardiogenic shock was present in every case 4 h after ligation. In FDP treated animals 4 h after ligation there was no fall in cardiac output and the systolic blood pressure was restored to pre-ligation values. Levels of serum creatine kinase isoenzyme (CK-MB), a highly specific indicator of myocardial cell damage, rose in the shocked (no FDP given) group, but remained low in the FDP treated group, equalling the levels measured in sham operated (no ligation) dogs. Samples of myocardium were taken from infarcted and adjacent normal regions 4 h after ligation for biochemical analysis. CK-MB concentrations in the infarcted region did not change from normal levels with FDP infusion; in the infarcted region lactate concentration (mumol.g-1 wet weight) fell from 18.48 in the control group to 7.90 in the FDP treated group. ATP levels in the infarcted region remained the same as those in the adjacent normal region with FDP treatment. It is concluded that infusion of FDP improves myocardial performance and metabolism following acute myocardial ischaemia.