Purines, lactate and phosphate release from child and adult heart during cardioplegic arrest

Smolenski, Ryszard T.; Świerczyński, Julian; Narkiewicz, M; Zydowo, M

doi:10.1016/0009-8981(90)90217-g

Cited by 30 publications

(15 citation statements)

References 15 publications

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“…46 Smolenski and colleagues on the basis of release of purines, lactate, and phosphate from the coronary sinus, however, suggested that the hearts of children two to 10 years of age were more metabolically vulnerable to cardioplegic arrest. 7 Myoglobin and the MB isoenzyme of creatine kinase are the conventional biochemical standards for quantifying myocardial injury after cardiac surgery although neither is exclusive to myocardium.' Cardiac troponin T and I are tissue specific isoforms of the respective subunits of the troponin regulatory complex whose systemic release implies myocardial damage.8 After surgical injury concentrations of myoglobin and CK-MB reach a peak earlier than those of the cardiac troponins, reflecting differences in molecular weights, cellular distribution, and plasma clearance.…”

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confidence: 99%

Vulnerability of paediatric myocardium to cardiac surgery.

Taggart

Hadjinikolas

Wong

et al. 1996

Heart

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Objective-Myocardial injury is an important cause of mortality and morbidity after paediatric cardiac surgery. Data obtained from studies in aniimals imply that juvenile myocardium is more resistant to the effects of ischaemia and reperfusion than adult myocardium but there is little confirmatory evidence in the clinical setting. Design-Prospective observational study of biochemical markers of myocardial injury in a paediatric population undergoing cardiac surgery. Setting-Tertiary referral centre for paediatric cardiac surgery. Patients-Forty patients undergoing paediatric cardiac surgery of varying complexity including closure of atrial and ventricular septal defects and arterial switch for simple transposition. A control group included patients undergoing thoracotomy for closure of a patent ductus arteriosus or repair of a coarctation. Interventions-Serial measurements of myoglobin, the MB isoenzyme of creatine kinase (CK-MB), and the highly specific markers of myocardial damage cardiac troponin T (cTnT) and I (cTnI) were made before and 1, 6, 24, and 48 to 72 hours after operation. Results-There were significant increases in myoglobin and CK-MB, but not cTnT or cTnI, in the control group. There were significant increases in the four biochemical markers in all the cardiac operations but especially in the ventricular septal defect and transposition group. Increases in CK-MB and cTnT were about five times greater than those previously reported in adult patients.Conclusions-(i) Cardiac troponins are more specific markers of myocardial injury in paediatric cardiac surgery than myoglobin and CK-MB. (ii) Paediatric myocardium seems to be more vulnerable to injury during cardiac surgery than adult myocardium.

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confidence: 99%

Vulnerability of paediatric myocardium to cardiac surgery.

Taggart

Hadjinikolas

Wong

et al. 1996

Heart

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“…An increase of nucleotide breakdown products release was also demonstrated during surgery of congenital and acquired heart defects (Fox el al., 1979;Smolenski et al, 1989Smolenski et al, ,1990b. Application of this approach for the evaluation of myocardial injury during heart transplantation seems to be particularly useful since the heart is subjected to ischaemia uninterrupted by multiple infusions of cardioplegic solution which flush some nucleotide breakdown products from the heart (Smolenski et al, 1989).…”

Section: Discussionmentioning

confidence: 97%

Liquid chromatographic evaluation of purine production in the donor human heart during transplantation

Smolenski

Yacoub

1993

Biomedical Chromatography

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A reversed phase high performance liquid chromatographic technique is presented allowing purine catabolite determination in a whole blood extract without a prior purification step. The method was applied to determine the timing and the profile of myocardial nucleotide catabolite release during reperfusion of the transplanted human heart. Samples of arterial and coronary sinus blood collected at various times within 1 h after aortic declamping during heart or heart-lung transplantations were used for nucleotide catabolite determination. Massive release of inosine and hypoxanthine from the heart was demonstrated. Production of adenosine was also shown but there was no liberation of xanthine or uric acid. Nucleotide catabolite release was greatest in the first 5 min (coronary sinus-arterial difference = 15-20 microM), but was still significant after 30 min of reperfusion. The determination of inosine and hypoxanthine--major catabolites released--was found to be reproducible in coronary sinus blood (coefficient of variation < 10%). However, immediate protein precipitation afer blood sample collection was necessary, as rapid metabolism of both exogenous and endogenous adenosine and inosine was demonstrated.

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“…Recently, Tanfani et al suggested that syn chronized AMP-D inhibition by ATP decrease and this association in heart shifts to adenosine production by 5'-NT [41]. The cardioplegia-arre sted human heart produces considerable amounts of adeno sine besides inosine [42,43]. However, IMP accumulates in human heart as well [43].…”

Section: Cardiac Imp Productionmentioning

confidence: 99%

“…The cardioplegia-arre sted human heart produces considerable amounts of adeno sine besides inosine [42,43]. However, IMP accumulates in human heart as well [43].…”

Section: Cardiac Imp Productionmentioning

confidence: 99%

Kinetics of adenylate metabolism in human and rat myocardium

Tavenier

Składanowski

Abreu

et al. 1995

Biochimica et Biophysica Acta (BBA) - General Subjects

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A bstractPathways producing and converting adenosine have hardly been investigated in human heart, contrasting work in other species. We compared the kinetics of enzymes associated with purine degradation and salvage in human and rat heart cytoplasm assaying for adenosine deaminase, nucleoside phosphorylase, xanthine oxidoreductase, AMP deaminase, AMP-and IMP-specific 5'-nucleotidases, adenosine kinase and hypoxanthine guanine phosphoribosyltransferase (HGPRT). Xanthine oxidoreductase was not detectable in human heart. The /Tm-values of the AMP-catabolizing enzymes were 2-5 times higher in human heart; the substrate affinity of the other enzymes was in the same order of magnitude in both species. The maximal activity (Vmax) of adenosine kinase was the same in both species, but HGPRT in man was only 12% of that in the rat. For human heart the VLax-values of adenosine deaminase, nucleoside phosphorylase, AMP-and IMP-specific 5'-nucleotidases, and AMP deaminase were 25-50% of those for rat heart. We conclude that human heart is less geared to purine catabolism than rat heart as is evident from the lower activities of the catabolic enzymes. Maintenance of the nucleotide pool may thus play a more important role in human heart.

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Purines, lactate and phosphate release from child and adult heart during cardioplegic arrest

Cited by 30 publications

References 15 publications

Vulnerability of paediatric myocardium to cardiac surgery.

Vulnerability of paediatric myocardium to cardiac surgery.

Liquid chromatographic evaluation of purine production in the donor human heart during transplantation

Kinetics of adenylate metabolism in human and rat myocardium

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