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Pyruvate-enriched cardioplegia suppresses cardiopulmonary bypass-induced myocardial inflammation.
MedLine Citation:
PMID:  20971256     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cardiopulmonary bypass-induced oxidative stress initiates inflammation that can damage the myocardium. This study tested whether cardioplegia enriched with the intermediary metabolite and antioxidant pyruvate dampens postbypass myocardial inflammation. METHODS: Pigs were maintained on cardiopulmonary bypass while their hearts were arrested for 60 minutes with 4:1 blood:crystalloid cardioplegia, in which the crystalloid contained 188 mM glucose ± 24 mM pyruvate. Pigs were weaned from bypass after 30 minutes of whole blood reperfusion and recovered for 4 hours. Glutathione (GSH) and glutathione disulfide (GSSG) were measured in coronary sinus plasma to indirectly monitor myocardial GSH redox state (GSH/GSSG). Left ventricular myocardium was sampled 4 hours after cardiopulmonary bypass for analyses of C-reactive protein, matrix metalloproteinases 2 and 9 and tissue inhibitor of metalloproteinase-2 (TIMP-2), and to assess neutrophil infiltration by histology and myeloperoxidase assay. RESULTS: Coronary sinus GSH/GSSG fell 70% after cardiopulmonary bypass with control cardioplegia, but pyruvate cardioplegia produced a robust increase in coronary sinus GSH/GSSG that persisted for 4 hours after bypass. Myocardial C-reactive protein content increased 5.6-fold after control bypass, and neutrophil infiltration and myeloperoxidase activity also increased, but pyruvate-fortified cardioplegia prevented these inflammatory effects. Control cardioplegia lowered myocardial TIMP-2 content by 59% and increased matrix metalloproteinase-9 activity by 35% versus nonbypass sham values, but pyruvate cardioplegia increased TIMP-2 content ninefold versus control cardioplegia and prevented the increase in matrix metalloproteinase-9. Matrix metalloproteinase-2 was not affected by bypass ± pyruvate. CONCLUSIONS: Pyruvate-enriched cardioplegia dampens cardiopulmonary bypass-induced myocardial inflammation. Increased GSH/GSSG and TIMP-2 may mediate pyruvate's effects.
Myoung-Gwi Ryou; Devin C Flaherty; Besim Hoxha; Hunaid Gurji; Jie Sun; Lisa M Hodge; Albert H Olivencia-Yurvati; Robert T Mallet
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-25     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1529-35     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Department of Integrative Physiology, University of North Texas Health Science Center, Fort Worth, Texas 76107-2699, USA.
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MeSH Terms
Antioxidants / pharmacology
C-Reactive Protein / analysis
Cardiopulmonary Bypass / adverse effects*
Glutathione / blood
Glutathione Disulfide / blood
Heart Arrest, Induced*
Matrix Metalloproteinase 2 / analysis
Matrix Metalloproteinase 9 / analysis
Myocarditis / etiology,  prevention & control*
Myocardium / pathology
Neutrophil Infiltration
Pyruvic Acid / pharmacology*
Tissue Inhibitor of Metalloproteinase-2 / analysis
Reg. No./Substance:
0/Antioxidants; 127-17-3/Pyruvic Acid; 127497-59-0/Tissue Inhibitor of Metalloproteinase-2; 27025-41-8/Glutathione Disulfide; 70-18-8/Glutathione; 9007-41-4/C-Reactive Protein; EC Metalloproteinase 2; EC Metalloproteinase 9
Comment In:
Ann Thorac Surg. 2010 Nov;90(5):1535-6   [PMID:  20971257 ]

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

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