Improved recovery of immature myocardium with l-glutamate blood cardioplegia

Paul W. Weldner, John L. Myers, Cynthia A. Miller, Juan D. Arenas, John A. Waldhausen

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Abstract

Enhancement of myocardial recovery with glutamate-enriched cold blood potassium cardioplegia (BPC) was evaluated using an isolated working heart model. Three groups of hearts from immature rabbits were subjected to 20 minutes of warm (37 °C) ischemia to allow energy depletion, followed by 90 minutes of hypothermic (10 °C) ischemia. Myocardial protection provided during hypothermia consisted of cardioplegia infusion, at 50 mm Hg every 30 minutes at 4 °C, of either St. Thomas' Hospital solution (group 1, n = 6), oxygenated BPC (group 2, n = 7), or oxygenated BPC enriched with 20 mmol/L l-glutamate (group 3, n = 7). Percent recovery of aortic flow was 87.6% ± 6.3% (results expressed as mean ± standard error of the mean) in group 3, which was significantly better than for either group 1 (63.4% ± 4.0%) or group 2 (47.0% ± 3.5%) (p < 0.05 by analysis of variance). Group 3 hearts had significantly better recovery of myocardial energy stores (μmol/g dry weight) compared with group 1 or 2 hearts: adenosine triphosphate, 17.8 ± 1.1 versus 12.4 ± 1.5 and 12.1 ± 0.4; creatine phosphate, 25.9 ± 1.8 versus 17.8 ± 1.8 and 20.3 ± 0.7; and glycogen, 140.7 ±12.6 versus 98.7 ± 9.9 and 60.7 ± 9.9 (p < 0.05). Glutamate-enriched BPC provided excellent myocardial protection after ischemia in this immature model, and this study quantitatively supports the use of glutamate-enriched BPC in neonatal clinical practice.

Original languageEnglish (US)
Pages (from-to)102-105
Number of pages4
JournalThe Annals of Thoracic Surgery
Volume55
Issue number1
DOIs
StatePublished - 1993

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Induced Heart Arrest
Glutamic Acid
Myocardium
Potassium
Ischemia
Phosphocreatine
Hypothermia
Glycogen
Analysis of Variance
Adenosine Triphosphate
Rabbits
Weights and Measures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Improved recovery of immature myocardium with l-glutamate blood cardioplegia. / Weldner, Paul W.; Myers, John L.; Miller, Cynthia A.; Arenas, Juan D.; Waldhausen, John A.

In: The Annals of Thoracic Surgery, Vol. 55, No. 1, 1993, p. 102-105.

Research output: Contribution to journalArticle

Weldner, Paul W. ; Myers, John L. ; Miller, Cynthia A. ; Arenas, Juan D. ; Waldhausen, John A. / Improved recovery of immature myocardium with l-glutamate blood cardioplegia. In: The Annals of Thoracic Surgery. 1993 ; Vol. 55, No. 1. pp. 102-105.
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abstract = "Enhancement of myocardial recovery with glutamate-enriched cold blood potassium cardioplegia (BPC) was evaluated using an isolated working heart model. Three groups of hearts from immature rabbits were subjected to 20 minutes of warm (37 °C) ischemia to allow energy depletion, followed by 90 minutes of hypothermic (10 °C) ischemia. Myocardial protection provided during hypothermia consisted of cardioplegia infusion, at 50 mm Hg every 30 minutes at 4 °C, of either St. Thomas' Hospital solution (group 1, n = 6), oxygenated BPC (group 2, n = 7), or oxygenated BPC enriched with 20 mmol/L l-glutamate (group 3, n = 7). Percent recovery of aortic flow was 87.6{\%} ± 6.3{\%} (results expressed as mean ± standard error of the mean) in group 3, which was significantly better than for either group 1 (63.4{\%} ± 4.0{\%}) or group 2 (47.0{\%} ± 3.5{\%}) (p < 0.05 by analysis of variance). Group 3 hearts had significantly better recovery of myocardial energy stores (μmol/g dry weight) compared with group 1 or 2 hearts: adenosine triphosphate, 17.8 ± 1.1 versus 12.4 ± 1.5 and 12.1 ± 0.4; creatine phosphate, 25.9 ± 1.8 versus 17.8 ± 1.8 and 20.3 ± 0.7; and glycogen, 140.7 ±12.6 versus 98.7 ± 9.9 and 60.7 ± 9.9 (p < 0.05). Glutamate-enriched BPC provided excellent myocardial protection after ischemia in this immature model, and this study quantitatively supports the use of glutamate-enriched BPC in neonatal clinical practice.",
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