Preservation of Myocardial Metabolism in Acute Coronary Artery Occlusions with Retrograde Coronary Sinus Perfusion and L-Carnitine in Dogs

Necrosis will be the eventual fate of myocardial ischemia which occurs after acute coronary occlusion. As antegrade reperfusion will be time consuming, a retrograde circulation will decreasc the intensity of necrosis and the infarered area will be reduced after the blood flow is rearranged. In our study, we performed retroinfusion of Lcarnıtıne, which activates the pyruvate dehydrogenase enzyme and by this way inercasing the aerobic utilisation of glucose, in our simplified retroperfusion system. There were ten mongrcl dogs, divided equally into carnitine and control groups. After taking the basa! values, the left anterior descending artery was occludcd. At the fiftccnth minute, in the carnitine group, 0.15 ının ol/kg of carnitine retroinfusion was perform ed . Thcn, hemodynamic and biochemical measuremcnts were made till the end of 120 minutes. The control group had no retroinfusion or medical therapy. The occlusion was ended in 60 minutes in both groups. In the carnitine group, there was stat istically significant difference for cardiac output ( 1375±50 ml/dk in control, 1625±75 ml/dk in carnitine group, p<0.05), cardiac index (62.5±2.3 ml/ kg/min in control, 81.25±3.7 ml/kg/min in carnitine group, p<0.05), m ean arteri al press u re (7 1 ±6 mmHg in control, 89±5 mmHg in carnitine, p<0.05). mcan pulmonary artery pressure (33±6 mmHg in control, 25±4 mmHg in carnitine, p<0.05), myocardial oxygen extraction (59±3 % in control, 50±2 % in carnitine, p<0.05) and myocardial lactate extraction ( -0.1 9±0.05 mmol/L in control, -0.09±0.03 mmoi/L in carnitine, p<0.05). Administration of L -carniıinc combined with simplified rctrograde coronary infusion has protective effects oh ischcınic myocardial metabolism and fu rther investigations are needed for the elinical trials.