Substrate enhancement of cardioplegic solution: Experimental studies and clinical evaluation

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background.: The development of myocardial protective strategies depends on a complete understanding of the pathophysiology of myocardial ischemia and reperfusion. This article reviews the rationale for inclusion of metabolic substrates in cardioplegic solutions on the basis of our current understanding of the underlying pathophysiologic pathways and speculates on the inclusion of future additives that await further investigation. Methods.: The pathophysiology of myocardial ischemia and reperfusion was evaluated from an extensive review of the pertinent literature. Experimental and clinical studies supporting the inclusion of metabolic substrates in clinical cardioplegic solutions were reviewed and summarized. Speculation on possible future additives to these formulas was made on the basis of encouraging, albeit preliminary, experimental data. Results.: Sound experimental and clinical evidence supports the inclusion of glucose, amino acids, calcium chelators, and oxygen as fundamental substrate additives to current cardioplegic solutions. Antioxidants, calcium-channel blockers, and tricarboxylic acid cycle intermediates may be of value. Adenosine, potassium-adenosine triphosphate channel modulators, and nitric oxide may join these lists after further research. Conclusions.: Substrate enhancement of clinical cardioplegic solutions is based on physiologic principles that have been confirmed in the clinical setting. Further definition of the intricacies of myocardial ischemia and reperfusion promises to expand the current list of additives.

Original languageEnglish
Pages (from-to)797-800
Number of pages4
JournalThe Annals of Thoracic Surgery
Volume60
Issue number3
DOIs
StatePublished - Jan 1 1995
Externally publishedYes

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Cardioplegic Solutions
Myocardial Reperfusion
Myocardial Ischemia
Citric Acid Cycle
Calcium Channel Blockers
Adenosine
Nitric Oxide
Antioxidants
Adenosine Triphosphate
Oxygen
Amino Acids
Glucose
Clinical Studies
Research

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Substrate enhancement of cardioplegic solution : Experimental studies and clinical evaluation. / Rosenkranz, Eliot.

In: The Annals of Thoracic Surgery, Vol. 60, No. 3, 01.01.1995, p. 797-800.

Research output: Contribution to journalArticle

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