Abstract
The aim of this study is to verify in an isolated working heart swine model if the acute administration of trimetazidine to cardioplegia, without pre-treatment improves heart performance. Eighteen pairs of swine were used in this working heart model, divided into three groups (n = 6) that underwent regional and global ischemia. Each group was selected to a different treatment: St. Thomas cardioplegia (ST), St. Thomas enriched with trimetazidine (TMZ) and control group (Co). Data was collected during reperfusion period at 30, 60 and 90 minutes. Hemodynamic parameters such as elastance contractility index (Emax), preload recruitable stroke work relationship (PRSW) and heart "stiffness" (EDPVR) were measured. Other data included coronary flow, lactate, oxygen and glucose consumption. Results were statistically analyzed. All contractility data were not significantly different among three groups. Lactate became constantly higher according to time uniformly in all three groups. Coronary flow, glucose consumption and oxygen consumption presented large variations during time periods but according to treatments showed no statistical differences in all three groups. Left ventricle final weight was significantly lower in trimetazidine group compared to both other groups. Administration of trimetazidine enhanced cardioplegia, without pre-treatment, showed no hemodynamic or metabolic improvement in swine isolated working heart model.
Highlights
Since the beginning of the use of CABG in cardiac surgery, several drugs have been associated to cardioplegic solutions aiming to promote resistance to ischemia and improvement in operations outcomes
Lactate became constantly higher according to time uniformly in all three groups
The aim of this study is to verify in a working heart swine model if the acute administration of trimetazidine - associated to cardioplegic solutions without pre-treatment – offers hemodynamic or metabolic benefit to the heart
Summary
Since the beginning of the use of CABG in cardiac surgery, several drugs have been associated to cardioplegic solutions aiming to promote resistance to ischemia and improvement in operations outcomes. Metabolic manipulation agents, such as the trimetazidine that due to its mode of action may offer interesting option for promoting resistance to ischemia in hearts undergone CPB [1]. The aim of this study is to verify in a working heart swine model if the acute administration of trimetazidine - associated to cardioplegic solutions without pre-treatment – offers hemodynamic or metabolic benefit to the heart
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