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J Thorac Cardiovasc Surg 1997;113:1068-1080
© 1997 Mosby, Inc.

CARDIOPULMONARY BYPASS,
MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

ASPARTATE/GLUTAMATE-ENRICHED BLOOD DOES NOT IMPROVE MYOCARDIAL ENERGY METABOLISM DURING ISCHEMIA-REPERFUSION: A 31P MAGNETIC RESONANCE SPECTROSCOPIC STUDY IN ISOLATED PIG HEARTS

Hooman R. Ghomeshi, BSca, Ganghong Tian, MD, PhDa, Jian Ye, MDa, Jiankang Sun, MSca, Edward F. Hoffenberg, MSca, Tomás A. Salerno, MD, MScb, Roxanne Deslauriers, PhDa

Supported by grants from the Medical Research Council of Canada. Partial support for Hooman R. Ghomeshi was provided by the Natural Sciences and Engineering Research Council of Canada.

Received for publication May 6, 1996 revisions requested June 18, 1996; revisions received Jan. 2, 1997 accepted for publication Feb. 13, 1997. Address for reprints: Dr. Roxanne Deslauriers, Institute for Biodiagnostics, National Research Council of Canada, 435 Ellice Ave., Winnipeg, Manitoba, Canada R3B 1Y6.

Abstract

Objective: Our objective was to test the effects of exogenous L-aspartate and L-glutamate on myocardial energy metabolism during ischemia-reperfusion. Methods: Phosphorus 31–magnetic resonance spectroscopy was used to observe cellular energetics and intracellular pH in isolated pig hearts perfused with blood (group A, n = 8) or blood enriched with 13 mmol/L each of L-aspartate and L-glutamate (group B, n = 6). The hearts were subjected to 30 minutes of total normothermic ischemia and then reperfused for 40 minutes. Two hearts from each group were inotropically stimulated by titration with calcium after normokalemic reperfusion. Left ventricular function was measured with the use of a compliant balloon and oxygen consumption was calculated. Results: Magnetic resonance spectroscopy showed no decrease in the rate of energy decline during ischemia for group B versus group A. No significant differences were observed between the two groups in terms of myocardial function, oxygen consumption, or the rate or extent of high-energy phosphate recovery after normokalemic reperfusion or inotropic stimulation. Inotropic stimulation of postischemic hearts, however, led to dramatic improvement in myocardial function in both groups (p < 0.05 for all parameters) and significant improvement in oxygen consumption (p = 0.01). Conclusions: In a normal, isolated, blood-perfused pig heart subjected to 30 minutes of total normothermic ischemia, (1) enrichment of the perfusate with aspartate/glutamate before and after ischemia affects neither myocardial energy metabolism during ischemia-reperfusion nor postischemic recovery of myocardial function or oxygen consumption and (2) inotropic stimulation can recruit significant postischemic function and sufficient aerobic respiration to support it, irrespective of aspartate/glutamate enrichment.






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