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Related Experiment Videos

Myocardial stunning: a therapeutic conundrum

Z Zhou1, R D Lasley, J O Hegge

  • 1Department of Surgery, University of Wisconsin, Madison 53792, USA.

The Journal of Thoracic and Cardiovascular Surgery
|November 1, 1995
PubMed
Summary

Dobutamine and pyruvate both improve heart function after stunning. However, dobutamine increases oxygen use and adenosine, while pyruvate boosts energy status in stunned hearts.

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Area of Science:

  • Cardiology
  • Cardiovascular Physiology
  • Biochemistry

Background:

  • Myocardial stunning, a form of postischemic dysfunction, impairs heart contractility.
  • The metabolic effects of inotropic agents like dobutamine and pyruvate on stunned myocardium are not fully understood.
  • Understanding these effects is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To compare the metabolic and functional effects of dobutamine and pyruvate in a porcine model of in vivo myocardial stunning.
  • To assess their impact on systolic wall thickening, myocardial energy status, interstitial adenosine levels, and oxygen consumption.

Main Methods:

  • Myocardial stunning was induced by a 10-minute occlusion of the left anterior descending coronary artery in pigs.
  • Following 30 minutes of reperfusion, animals received either intravenous dobutamine or intracoronary pyruvate.

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  • Measurements included systolic wall thickening, myocardial phosphorylation potential index, interstitial adenosine, and myocardial oxygen consumption.

    • Main Results:

    • Both dobutamine and pyruvate improved regional systolic wall thickening.
    • Dobutamine increased myocardial oxygen consumption and interstitial adenosine, indicating myocardial de-energization (phosphorylation potential index decreased from 0.17 to 0.09).
    • Pyruvate enhanced myocardial energy status (phosphorylation potential index increased from 0.20 to 0.55) without similar adverse metabolic changes.

    Conclusions:

    • While both agents improve function, dobutamine's metabolic effects may be suboptimal for treating myocardial stunning.
    • Pyruvate demonstrates a beneficial effect on myocardial energy metabolism in stunned hearts.
    • Further research is needed to determine the optimal therapeutic approach for stunned myocardium.