Document Detail

The effect of lactate infusion on myocardial metabolism and ventricular function following ischemia and cardioplegia.
MedLine Citation:
PMID:  2310994     Owner:  NLM     Status:  MEDLINE    
Impaired myocardial fatty acid and glucose metabolism following ischemia and cardioplegia may limit the recovery of myocardial oxidative metabolism and ventricular function. Lactate, a simple three carbon compound, can be readily metabolized to pyruvate and is possibly the preferred substrate for aerobic metabolism. Therefore, increasing arterial lactate concentrations may improve myocardial metabolic recovery after ischemia and cardioplegia. Myocardial lactate metabolism and ventricular function were assessed in a canine model of 45 mins of global normothermic ischemia followed by 60 mins of cold potassium cardioplegic arrest. Thirteen dogs received a perioperative infusion of sodium lactate to elevate arterial concentrations (from 6 to 12 mmol/L) and 12 dogs received an equivalent amount of saline. The high arterial lactate concentrations were associated with an increased myocardial lactate consumption and oxidation (as assessed by 14C-labelled lactate) during reperfusion. Myocardial ATP concentrations fell during reperfusion despite improved myocardial oxidation. The recovery of ventricular function (as assessed by a compliant intraventricular balloon) was incomplete and only marginally better with the high arterial lactate concentrations. An infusion of lactate improved myocardial oxidative metabolism following ischemia and cardioplegia. However, the recovery of ventricular function was incomplete perhaps because of inadequate preservation of myocardial ATP.
K H Teoh; D A Mickle; R D Weisel; M M Madonik; J Ivanov; R D Harding; A D Romaschin; G J Wilson; J C Mullen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  6     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:    1990 Jan-Feb
Date Detail:
Created Date:  1990-04-19     Completed Date:  1990-04-19     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  38-46     Citation Subset:  IM    
Division of Cardiovascular Surgery, Toronto General Hospital, Ontario.
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MeSH Terms
Adenosine Triphosphate / metabolism
Analysis of Variance
Coronary Circulation
Coronary Disease / metabolism,  physiopathology*,  surgery
Disease Models, Animal
Fatty Acids / metabolism*
Glucose / metabolism*
Heart Arrest, Induced
Heart Ventricles / physiopathology*
Infusions, Intravenous
Lactates / metabolism,  pharmacology*
Myocardial Reperfusion
Myocardium / metabolism*
Phosphocreatine / metabolism
Reg. No./Substance:
0/Fatty Acids; 0/Lactates; 50-99-7/Glucose; 56-65-5/Adenosine Triphosphate; 67-07-2/Phosphocreatine

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