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5'-Nucleotidase inhibition enhances postischemic myocardial performance
T A Schwann1, K W Lobdell, J Braxton
1Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06510.
The Journal of Surgical Research
|April 1, 1994
Summary
Adenosine methylene diphosphate (AMPCP), a 5'-nucleotidase inhibitor, improved myocardial function after ischemia. This agent enhances recovery of systolic function and myocardial compliance during cardiac surgery.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biochemistry
Background:
- Cold crystalloid cardioplegia is a standard method for myocardial protection during cardiac surgery.
- 5 '-nucleotidase plays a role in myocardial energy metabolism.
- Adenosine methylene diphosphate (AMPCP) is a 5 '-nucleotidase inhibitor.
Purpose of the Study:
- To evaluate AMPCP as an adjunct to cold crystalloid cardioplegia for myocardial protection.
- To assess the impact of AMPCP on postischemic myocardial performance in vivo.
Main Methods:
- Mongrel dogs underwent cardiopulmonary bypass and 150 minutes of myocardial ischemia.
- The control group received standard cold crystalloid cardioplegia.
- The experimental group received cardioplegia supplemented with AMPCP (250 microM).
- Hemodynamic parameters and Starling curves were analyzed post-CPB.
Main Results:
- Recovery of cardiac index, mean arterial pressure, heart rate, and left ventricular pressure was similar between groups.
- Statistically significant improvement in myocardial compliance (-dP/dt) was observed in the AMPCP group.
- Enhanced recovery of systolic function (+dP/dt) was noted with AMPCP supplementation.
Conclusions:
- AMPCP as an adjunct to cold crystalloid cardioplegia enhances postischemic myocardial performance.
- AMPCP may be beneficial for myocardial protection during prolonged global ischemia in cardiac surgery.