Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Hermann, HP; Arp, J; Pieske, B; Kögler, H; Baron, S; Janssen, PM; Hasenfuss, G.
Improved systolic and diastolic myocardial function with intracoronary pyruvate in patients with congestive heart failure.
Eur J Heart Fail. 2004; 6(2):213-218
Doi: 10.1016/j.ejheart.2003.10.001
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- Co-Autor*innen der Med Uni Graz
- Pieske Burkert Mathias
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- Abstract:
- BACKGROUND: Pyruvate increases myocardial performance in isolated myocardium and improves hemodynamics in patients with congestive heart failure. AIMS: To investigate the influence of pyruvate on detailed parameters of systolic and diastolic left ventricular (LV) function. METHODS AND RESULTS: In patients with heart failure due to dilated cardiomyopathy (LVEF 30+/-4%, n=9) pyruvate was infused intracoronarily. LV function was analysed before, during and after application of different pyruvate concentrations using a LV-micromanometer catheter. LV volumes were determined using cine ventriculography. Pyruvate increased maximum rate of LV isovolumic pressure rise (Peak +dP/dt) from 802+/-106 to 1125+/-103 mmHg/s (P<0.05). Left ventricular end-diastolic pressure declined in parallel from 17+/-2 to 12+/-2 mmHg (P<0.05) and heart rate decreased from 79+/-4 to 72+/-5 min(-1) (P<0.05). Stroke volume index increased from 34+/-4 to 43+/-6 ml/m(2) (P<0.05), end-diastolic LV volume remained unchanged, thus left ventricular ejection fraction increased with pyruvate from 30+/-4 to 39+/-4% (P<0.05). Maximum rate of LV isovolumic pressure decline (Peak -dP/dt) was significantly increased with pyruvate (from 794+/-94 to 980+/-108 mmHg/s; P<0.05) and mean arterial pressure increased from 80+/-5 to 88+/-4 mmHg (P<0.05). Discontinuation of pyruvate resulted in immediate reversibility of its effects. CONCLUSION: Intracoronary pyruvate improves systolic and diastolic myocardial function and increases ejection fraction without increasing heart rate. Pyruvate thus exhibits the profile of a favourable inotropic agent, however, further investigation for the treatment of patients with acute heart failure is mandatory.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Blood Pressure -
- Cardiotonic Agents - therapeutic use
- Female - therapeutic use
- Heart Failure, Congestive - drug therapy
- Heart Rate - drug therapy
- Hemodynamic Processes - drug therapy
- Humans - drug therapy
- Male - drug therapy
- Middle Aged - drug therapy
- Pyruvic Acid - therapeutic use
- Stroke Volume - therapeutic use
- Treatment Outcome - therapeutic use
- Ventricular Function, Left - drug effects
- Find related publications in this database (Keywords)
- pyruvate
- inotropic agents
- heart failure
- sarcoplasmic reticulum