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Ann Thorac Surg 1987;43:168-171
© 1987 The Society of Thoracic Surgeons

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Articles

Preliminary Evaluation of Cocarboxylase on Myocardial Protection of the Rat Heart

From the Department of Surgery, Albert Einstein Medical Center, Northern Division, Philadelphia, PA Department of Surgery, Allegheny-Singer Research Institute, Allegheny General Hospital, Pittsburgh, PA

Accepted for publication March 10, 1986.

^* Address reprint requests to Dr. Larrieu, Albert Einstein Medical Center-ND, York and Tabor Roads, Klein POB—Suite 510, Philadelphia, PA 19141

The presence of cocarboxylase (CC) is essential for the oxidation of pyruvate to acetylcoenzyme A (acetyl-CoA) and its subsequent degradation by means of the Krebs cycle. We compared the effects of various concentrations of CC in a cardioplegic solution on the survival and hemodynamic and metabolic recovery of 23 isolated, working rat hearts subjected to 60 minutes of hypothermic (23°C) ischemic arrest. Group 1 (N = 6) consisted of hearts infused with the basic cardioplegic solution (Tyers' solution with glucose), to which no CC was added. In group 2 (N = 6) CC was added at 0.1 ml/L to the cardioplegic solution. In group 3 (N = 5) CC was added at 1 ml/L, and in group 4 (N = 6) CC was added at 10 ml/L. The cardioplegic infusions were performed at a pressure of 40 mm Hg for 2 minutes just before arrest; 30 minutes later they were performed again for 1 minute. Only two hearts (33.3%) recovered in group 1 whereas five recovered in group 2, five (100%) in group 3, and five (83.3%) in group 4. The recovery of hemodynamic performance as a percentage of pre-ischemic control values showed marked improvement in the CC groups, especially group 3, when compared with group 1.

The metabolic variables in the CC groups were also markedly improved, with significantly (p < .05) decreased levels of tissue lactate and increased levels of creatine phosphate compared with those in group 1. Tissue glycogen content was also significantly increased in groups 2 and 3, whereas accumulation of glucose 6-phosphatase was unchanged. These results suggest that CC improves the hemodynamic and metabolic variables in rat hearts subjected to ischemic cardiac arrest and may be an effective additive to a cardioplegic solution.

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