I. Vanhanen et al., INTRAVENOUS ASPARTATE INFUSION AFTER A CORONARY OPERATION - EFFECTS ON MYOCARDIAL-METABOLISM AND HEMODYNAMIC STATE, The Annals of thoracic surgery, 65(5), 1998, pp. 1296-1302
Citations number
21
Categorie Soggetti
Surgery,"Cardiac & Cardiovascular System","Respiratory System
Background. In a previous study glutamate infusion after coronary arte
ry bypass grafting was associated with beneficial effects on myocardia
l metabolism and myocardial performance. It has been claimed that aspa
rtate is more important than glutamate for the recovery of myocardial
metabolism after cardioplegic arrest. Therefore, the metabolic and hem
odynamic effects of aspartate were studied after coronary artery bypas
s grafting. Methods. Fifty to 240 mL of a 0.1 mol/L aspartic acid solu
tion was infused intravenously during 60 minutes in 10 patients early
after coronary artery bypass grafting. Myocardial metabolism was studi
ed using the coronary sinus catheter technique. Results. Aspartate inf
usion caused a significant increase in the arterial levels of both asp
artate and glutamate. This was associated with a significant increase
in myocardial uptake of aspartate and a decrease in myocardial uptake
of glutamate. Myocardial exchange of other substrates remained unaffec
ted. There were no changes in hemodynamic state except an increase of
heart rate and pulmonary vascular resistance. Conclusions. Interaction
s with glutamate metabolism, compatible with competitive inhibition of
myocardial glutamate uptake, which may have outweighed potential effe
cts of aspartate, were observed. Recognition of these amino acid inter
actions is important as they are used together as additives in cardiop
legic solutions. (C) 1998 by The Society of Thoracic Surgeons.