Reduction of Intraoperative Myocardial Infarction by Means of Exogenous Anaerobic Substrate Enhancement: Prospective Randomized Study

Lolley, David M.; Ray, Jefferson F.; Myers, Wayne L.; Sheldon, Gregory; Sautter, Richard D.

doi:10.1016/s0003-4975(10)62937-2

Cited by 42 publications

(8 citation statements)

References 20 publications

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“…The protective effect of glycolysis in ischemic myocardium may occur via a number of mechanisms (Weiss and Hiltbrand, 1985; Uchida and Doi, 1994; Xu et al, 1995; Askenasy, 2001; Vogt et al, 2003). Manipulations that increase cardiac glycogen reduce ischemic cardiac contracture and injury and improve post-ischemic function, though the exact role of glycogen in these effects remains unclear (Lolley et al, 1978; Oldfield et al, 1986; Schneider and Taegtmeyer, 1991; Doenst et al, 1996; Schaefer and Ramasamy, 1997; Eynan et al, 2002). …”

Section: Discussionmentioning

confidence: 99%

Low carbohydrate diet decreases myocardial insulin signaling and increases susceptibility to myocardial ischemia

2008

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Aims-Low Carbohydrate Diets (LCD) are a popular intervention for weight loss, but the effect of such diets on myocardial ischemia is not known. Myocardial energy substrates and insulin signaling pathways may be affected by these diets, and both may play a role in protection of ischemic myocardium. We investigated whether LCD increases susceptibility to cardiac injury during ischemia and reperfusion in the isolated rat heart.Main Methods-Rats were fed LCD (60% kcal from fat / 30% protein / 10% carbohydrate) or a control diet (CONT; 16% / 19% / 65%) for 2 weeks. Hearts from rats fed with LCD or CONT were isolated and subjected to normal perfusion in Langendorff mode, with 30 min global low flow ischemia (LFI; 0.3 ml/min) followed by 60 min reperfusion, or 60 min LFI followed by 120 min reperfusion.Key Findings-LCD diet led to an increase in 3-hydroxybutyrate and lower circulating insulin. LCD diet also resulted in impaired left ventricular performance during LFI, reduced recovery of function following LFI and reperfusion, and 10-to 20-fold increased injury as measured by lactate dehydrogenase release and histologic infarct area. LCD diet also led to lower myocardial glycogen stores and glycogen utilization during LFI, and lower insulin signaling as assessed by Akt phosphorylation at the end of LFI and reperfusion, but no differences in ERK 1/2 phosphorylation.Significance-These results demonstrate that LCD affects myocardial energy substrates, affects insulin signaling, and increases myocardial injury following ischemia-reperfusion in the isolated heart.

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Section: Discussionmentioning

confidence: 99%

Low carbohydrate diet decreases myocardial insulin signaling and increases susceptibility to myocardial ischemia

2008

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“…15,17,19,45,46,50 Therefore, it appears that the potential benefit of GIK infusion for myocardial infarction is attenuated with concomitant use of reperfusion therapy. However, GIK infusion may still have in important role in the period before reper- 15,17,19,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]42,[44][45][46][47][49][50][51]53 32 26234 9.98 0.96 (0.89-1.03) GIK in AMI 15,17,19,[22][23][24][25][26][27][28][29][30]…”

Section: Methods Of Insulin Administration Gik Vs Non-gikmentioning

confidence: 99%

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

Pittas

Siegel

Lau

2006

J Parenter Enteral Nutr

151

111

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“…11]. On the other hand, bloodless GIK cardioplegia also enhances anaerobic metabolism and results in substantial protection of the ischemic ar rested heart [12][13][14]. Nevertheless, anaerobic metabolism duringbloodlesscardioplegiacannot always produce the necessary amount of high energy phosphate because the accumu lation of lactic acid or other acid metaboli tes inhibitsenzymeactivity unless theaccumulated acid metabolites are effectively washed out by multidose cardioplegia [15,16].…”

Section: Discussionmentioning

confidence: 99%

Effect of Temperature on the Arrested Heart Exposed to a 4-Hour Ischemia during Blood Potassium Cardioplegia

et al. 1983

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This study was undertaken to evaluate the optimal myocardial temperature during a 4-hour ischemia induced by blood potassium cardioplegia (PC). Heart-lung preparations with work load circuit were used as experimental model. 24 mongrel dogs were divided into four groups and two myocardial temperatures (moderate hypothermia, deep hypothermia) and two perfusates (PC with blood, PC without blood) were tested. Parameters used to evaluate the myocardial protection include the coronary sinus blood pH of the initial reperfusion and left ventricular stroke work after resuscitation. In blood PC at moderate hypothermia, deleterious acid metabolites were minimally produced as evidenced by the coronary sinus blood pH (7.221 ± 0.122) at initial reperfusion, and cardiac function was best recovered in this group. Blood PC at moderate hypothermia allows the heart to tolerate 4 h ischemia without an excessively elevated coronary perfusion pressure during cardioplegic infusion.

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Reduction of Intraoperative Myocardial Infarction by Means of Exogenous Anaerobic Substrate Enhancement: Prospective Randomized Study

Cited by 42 publications

References 20 publications

Low carbohydrate diet decreases myocardial insulin signaling and increases susceptibility to myocardial ischemia

Low carbohydrate diet decreases myocardial insulin signaling and increases susceptibility to myocardial ischemia

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

Effect of Temperature on the Arrested Heart Exposed to a 4-Hour Ischemia during Blood Potassium Cardioplegia

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