Hp. Hermann et al., Haemodynamic effects of intracoronary pyruvate in patients with congestiveheart failure: an open study, LANCET, 353(9161), 1999, pp. 1321-1323
Citations number
21
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Background Pyruvate, as an intermediate in the Krebs cycle, is an important
source of energy for myocardium and improves contractility of normal, hypo
xic, and postischaemic animal myocardium. We investigated the effect of int
racoronary pyruvate in patients with congestive heart failure.
Methods Haemodynamic measurements were done in eight patients with dilated
cardiomyopathy after two 15 min infusions of pyruvate into the left main co
ronary artery and after saline washout of pyruvate.
Findings There were no significant differences between the two pyruvate con
centrations. Application of pyruvate resulted in a 23% increase in cardiac
index (p<0 . 05), a 38% increase in stroke-volume index (p<0 . 05), and a 3
6% decrease in pulmonary capillary wedge pressure (p<0 . 05). Heart rate de
creased significantly by 11%. Mean aortic pressure and systemic vascular re
sistance did not change. Most of the effects of pyruvate were reversed 15 m
in after the infusion stopped.
Interpretation Pyruvate has the profile of a favourable inotropic substance
. Other modes of administration need to be studied.