Document Detail


Improved systolic and diastolic myocardial function with intracoronary pyruvate in patients with congestive heart failure.
MedLine Citation:
PMID:  14984729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pyruvate increases myocardial performance in isolated myocardium and improves hemodynamics in patients with congestive heart failure.
AIMS: To investigate the influence of pyruvate on detailed parameters of systolic and diastolic left ventricular (LV) function.
METHODS AND RESULTS: In patients with heart failure due to dilated cardiomyopathy (LVEF 30+/-4%, n=9) pyruvate was infused intracoronarily. LV function was analysed before, during and after application of different pyruvate concentrations using a LV-micromanometer catheter. LV volumes were determined using cine ventriculography. Pyruvate increased maximum rate of LV isovolumic pressure rise (Peak +dP/dt) from 802+/-106 to 1125+/-103 mmHg/s (P<0.05). Left ventricular end-diastolic pressure declined in parallel from 17+/-2 to 12+/-2 mmHg (P<0.05) and heart rate decreased from 79+/-4 to 72+/-5 min(-1) (P<0.05). Stroke volume index increased from 34+/-4 to 43+/-6 ml/m(2) (P<0.05), end-diastolic LV volume remained unchanged, thus left ventricular ejection fraction increased with pyruvate from 30+/-4 to 39+/-4% (P<0.05). Maximum rate of LV isovolumic pressure decline (Peak -dP/dt) was significantly increased with pyruvate (from 794+/-94 to 980+/-108 mmHg/s; P<0.05) and mean arterial pressure increased from 80+/-5 to 88+/-4 mmHg (P<0.05). Discontinuation of pyruvate resulted in immediate reversibility of its effects.
CONCLUSION: Intracoronary pyruvate improves systolic and diastolic myocardial function and increases ejection fraction without increasing heart rate. Pyruvate thus exhibits the profile of a favourable inotropic agent, however, further investigation for the treatment of patients with acute heart failure is mandatory.
Authors:
Hans-Peter Hermann; Jordis Arp; Burkert Pieske; Harald Kögler; Steffen Baron; Paul M L Janssen; Gerd Hasenfuss
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of heart failure     Volume:  6     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-02-26     Completed Date:  2004-09-21     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  213-8     Citation Subset:  IM    
Affiliation:
Abteilung Kardiologie und Pneumologie, Georg-August-Universität Göttingen, Robert-Koch-Str. 40, Göttingen D-37075, Germany. phermann@med-uni-goettingen.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure
Cardiotonic Agents / therapeutic use*
Female
Heart Failure / drug therapy*
Heart Rate
Hemodynamics
Humans
Male
Middle Aged
Pyruvic Acid / therapeutic use*
Stroke Volume
Treatment Outcome
Ventricular Function, Left / drug effects*
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 127-17-3/Pyruvic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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