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Ann Thorac Surg 2001;71:254-259
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Effects of carnitine on cardiac function after cardioplegic ischemia in neonatal rabbit hearts

Shintaro Nemoto, MDa, Mitsuru Aoki, MDa, Chang Dehua, MDa, Yasuharu Imai, MDa

a Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, Tokyo, Japan

Accepted for publication June 1, 2000.

Address reprint requests to Dr Nemoto, Department of Medicine—Cardiology, Veterans Affairs Medical Center, Laboratories of Cardiac Molecular and Cellular Physiology, Baylor College of Medicine, Rm 243, Bldg 110, 2002 Holcombe Blvd, Houston, TX 77030
e-mail: snemoto{at}bcm.tmc.edu

Background. Ischemia immediately impairs myocardial fatty acid metabolism and reduces the concentration of carnitine which is an essential cofactor for fatty acid metabolism in the mitochondria. The purpose of this study was to investigate the effects of carnitine administration on recovery of cardiac function after cardioplegic ischemia in the neonatal heart where fatty acid metabolism is not a predominant source of adenosine triphosphate.

Methods. Isolated blood-perfused neonatal rabbit hearts underwent 3 hours of cold cardioplegic ischemia. The control group (n = 10) was reperfused with unmodified diluted blood. The carnitine group (n = 10) was reperfused with the blood containing 5 mM/L of carnitine. Before ischemia (base line) and after 15 and 30 minutes reperfusion, left ventricular (LV) function and LV compliance were measured using a intraventricular conductance catheter combined with an isovolumic balloon. Coronary blood flow was measured and myocardial oxygen consumption was calculated.

Results. Carnitine significantly improved not only LV systolic function but also LV diastolic function (p < 0.05) as well as LV compliance after ischemia. Coronary blood flow and myocardial oxygen consumption were significantly improved after ischemia in the carnitine group compared with the control group (p < 0.05).

Conclusions. These results suggest that carnitine strikingly improves LV functional recovery and aerobic metabolism after cold cardioplegic arrest, and may improve cardiac performance in neonates after open heart surgery.






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Copyright © 2001 by The Society of Thoracic Surgeons.