Creatine Mobilization in Myocardial Damage

Abstract

In our clinical studies the discovery of a hypercreatinemia and creatinuria following coronary thrombosis with cardiac infarction and in acute myocardial insufficiency with congestive failure prompted us to attempt to establish a curve of creatine excretion. Old male dogs that showed no creatinuria, on a diet of 150 gm. of dried bread and 200 cc. of evaporated milk with chopped cabbage and charcoal, were selected and varying grades of obstruction to the coronary circulation were produced with a minimal amount of skeletal muscle trauma. Under amytal anesthesia the right carotid artery was carefully exposed by a separation of the muscles, a lead impregnated ureteral catheter was guided, under the fluoroscope, through an opening in the carotid down into one of the aortic sinuses. With the tip opposite a coronary orifice a large or a small drop of metallic mercury was run in from a syringe. Thirty grams of glucose in 200 cc. evaporated milk was given by tube immediately after operation and repeated in 12 hours, after which the dog usually took all of his diet. A constant intake of food was maintained. A flash roentgenogram established the position of the mercury in the coronary system. Electrocardiograms taken before and at intervals following the injection presented graphic evidence of myocardial infarction. In a series of 12 dogs a creatinuria developed within a day except in the very slight infarctions in which it sometimes appeared on the second or third day. The creatinuria then increased as is shown in Table I of Dog No. 12, to reach its maximum about the sixth day. It then dropped off to disappear according to the extent of the damage between the tenth and fourteenth day.