Alpha-ketoglutarate for myocardial protection in heart surgery.
A low myocardial content of alpha-ketoglutarate during heart surgery might aggravate ischaemic injury. 24 men undergoing coronary surgery participated in a randomised controlled study. 28 g alpha-ketoglutarate was added to blood cardioplegia for intermittent antegrade intracoronary perfusion in 13 cases. alpha-ketoglutarate reduced the appearance in blood of the ischaemic markers creatine kinase MB and troponin T (at 4 h after release of aortic cross-clamp; median [95% CI] 49 [37-60] micrograms/L in controls vs 32 [27-37] micrograms/L for creatine kinase MB, 2.0 [1.2-2.8] vs 1.1 [0.8-1.4] micrograms/L for troponin T). These findings signify attenuated ischaemic injury, possibly secondary to enhanced myocardial oxidative capacity.
Kjellman
U
U
Department of Thoracic and Cardiovascular Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Björk
K
K
Ekroth
R
R
Karlsson
H
H
Jagenburg
R
R
Nilsson
F
F
Svensson
G
G
Wernerman
J
J
D000368:Aged; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003327:Coronary Disease / Q000601:surgery; D003402:Creatine Kinase / Q000097:blood; D006801:Humans; D007527:Isoenzymes; D007656:Ketoglutaric Acids / Q000008:administration & dosage*; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D008297:Male; D017202:Myocardial Ischemia / Q000517:prevention & control; D009206:Myocardium / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism; D014336:Troponin / Q000097:blood
D002314:Cardioplegic Solutions; D007527:Isoenzymes; D007656:Ketoglutaric Acids; D007773:Lactates; D014336:Troponin; D019344:Lactic Acid; D003402:Creatine Kinase; D010100:Oxygen