Myocardial metabolism assessed by microdialysis: A prospective randomized study in on- and off-pump coronary bypass surgery

Mantovani, Vittorio; Kennergren, Charles; Bugge, Mogens; Sala, A.; Lönnroth, Peter; Berglin, Eva

doi:10.1016/j.ijcard.2009.03.033

Cited by 18 publications

(8 citation statements)

References 25 publications

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“…All procedures were conducted in adherence to the manufacturer’s instructions using the original (manufacturer-supplied) reagent kits and calibrators. The analytic methods were based on enzymatic colorimetric assays [ 19 ]. All samples were collected in glass vials and sealed with Chromacol crimp caps (Thermo Scientific, Waltham, MA, USA) directly after sampling.…”

Section: Methodsmentioning

confidence: 99%

The protective effects of a phosphodiesterase 5 inhibitor, sildenafil, on postresuscitation cardiac dysfunction of cardiac arrest: metabolic evidence from microdialysis

et al. 2014

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IntroductionRecent experimental and clinical studies have indicated the cardioprotective role of sildenafil during ischemia/reperfusion injury. The aim of this study was to determine, by obtaining metabolic evidence from microdialysis, if sildenafil could reduce the severity of postresuscitation myocardial dysfunction and lead to cardioprotection through beneficial effects on energy metabolism.MethodsTwenty-four male piglets were randomly divided into three groups: sildenafil (n = 8), saline (SA; n = 8) and sham operation (n = 8). Sildenafil pretreatment consisted of 0.5 mg/kg sildenafil administered once intraperitoneally 30 minutes prior to ventricular fibrillation (VF). The myocardial interstitial fluid (ISF) concentrations of glucose, lactate, pyruvate, glutamate and glycerol were determined by microdialysis before VF. Afterward, the piglets were subjected to 8 minutes of untreated VF followed by 15 minutes of open-chest cardiopulmonary resuscitation. ISF was collected continuously, and the experiment was terminated 24 hours after resuscitation.ResultsAfter 8 minutes of untreated VF, the sildenafil group exhibited higher glucose and pyruvate concentrations of ISF and lower lactate and glutamate levels in comparison with the SA group, and these data reached statistical significance (P < 0.05). Advanced cardiac life support was delivered to both groups, with a 24-hour survival rate showing a promising trend in the sildenafil group (7 of 8 versus 3 of 8 survivors, P < 0.05). Compared with the SA group, the sildenafil group had a better outcome in terms of hemodynamic and oxygen metabolism parameters (P < 0.05). Myocardial tissue analysis revealed a dramatic increase in the contents of ATP, ADP and phosphocreatine in the sildenafil group versus the SA group at 24 hours after return of spontaneous circulation (ROSC; P = 0.03, P = 0.02 and P = 0.02, respectively). Furthermore, 24 hours after ROSC, the sildenafil group had marked elevations in activity of left ventricular Na+-K+-ATPase and Ca2+-ATPase compared with the SA group (P = 0.03, P = 0.04, respectively).ConclusionsSildenafil could reduce the severity of postresuscitation myocardial dysfunction, and it produced better clearance of metabolic waste in the ISF. This work might provide insights into the development of a novel strategy to treat postresuscitation myocardial dysfunction.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-014-0641-7) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

The protective effects of a phosphodiesterase 5 inhibitor, sildenafil, on postresuscitation cardiac dysfunction of cardiac arrest: metabolic evidence from microdialysis

et al. 2014

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“…Our comprehensive search identified 18 RCTs of off-pump versus on-pump CABG [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (Table 1). In total, our meta-analysis included data on 5358 patients randomized to off-pump or on-pump CABG.…”

mentioning

confidence: 99%

Ask not which can impair early morbidity—ask which can improve late survival: A meta-analysis of randomized trials of off-pump versus on-pump coronary artery bypass

Takagi¹,

Yamamoto²,

Iwata³

et al. 2012

International Journal of Cardiology

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“…2 31 This results in very low sensitivity in detecting perioperative myocardial ischaemia 32 in contrast to direct monitoring of myocardial function 31 and metabolism. 14 Normal cellular metabolism requires sufficient coronary blood flow delivered by a patent graft. 7 Graft blood flow is possible to monitor before closure of the thoracic incision.…”

Section: Discussionmentioning

confidence: 99%

“…23 Microdialysis catheters (CMA 71, 100 kDa cut-off, 2 cm membrane, 1 ml min 21 flow, M Dialysis, Solna, Sweden) were placed in graft dependent and Cx-dependent myocardium. The microdialysis technique is an established method used both experimentally and clinically 14…”

Section: Surgerymentioning

confidence: 99%

Myocardial tissue CO 2 tension detects coronary blood flow reduction after coronary artery bypass in real-time †

Pischke¹,

Hyler

Tronstad³

et al. 2015

British Journal of Anaesthesia

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Myocardial metabolism assessed by microdialysis: A prospective randomized study in on- and off-pump coronary bypass surgery

Cited by 18 publications

References 25 publications

The protective effects of a phosphodiesterase 5 inhibitor, sildenafil, on postresuscitation cardiac dysfunction of cardiac arrest: metabolic evidence from microdialysis

The protective effects of a phosphodiesterase 5 inhibitor, sildenafil, on postresuscitation cardiac dysfunction of cardiac arrest: metabolic evidence from microdialysis

Ask not which can impair early morbidity—ask which can improve late survival: A meta-analysis of randomized trials of off-pump versus on-pump coronary artery bypass

Myocardial tissue CO 2 tension detects coronary blood flow reduction after coronary artery bypass in real-time †

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