Effects of inosine on reperfusion injury after cardiopulmonary bypass.

Abstract

OBJECTIVE:

Inosine, a break-down product of adenosine has been recently shown to exert inodilatory and anti-inflammatory properties. Furthermore inosine might be a key substrate of pharmacological post-conditioning. In the present pre-clinical study, we investigated the effects of inosine on cardiac function during reperfusion in an experimental model of cardioplegic arrest and extracorporal circulation.

METHODS:

Twelve anesthetized dogs underwent hypothermic cardiopulmonary bypass. After 60 minutes of hypothermic cardiac arrest, reperfusion was started after application of either saline vehicle (control, n = 6), or inosine (100 mg/kg, n = 6). Left ventricular end-systolic pressure volume relationship (ESPVR) was measured by a combined pressure-volume-conductance catheter at baseline and after 60 minutes of reperfusion. Left anterior descendent coronary blood flow (CBF), endothelium-dependent vasodilatation to acetylcholine (ACh) and endothelium-independent vasodilatation to sodium nitroprusside (SNP) were also determined.

RESULTS:

The administration of inosine led to a significantly better recovery (given as percent of baseline) of ESPVR 90 ± 9% vs. 46 ± 6%, p < 0.05. CBF and was also significantly higher in the inosine group (56 ± 8 vs. 23 ± 4, ml/min, p < 0.05). While the vasodilatatory response to SNP was similar in both groups, ACh resulted in a significantly higher increase in CBF (58 ± 6% vs. 25 ± 5%, p < 0.05) in the inosine group.

CONCLUSIONS:

Application of inosine improves myocardial and endothelial function after cardiopulmonary bypass with hypothermic cardiac arrest.

• Authors: Gábor Veres, Tamás Radovits, Leila Seres, Ferenc Horkay, Matthias Karck, Gábor Szabó
• Journal: Journal of cardiothoracic surgery (J Cardiothorac Surg) Vol. 5 Pg. 106 (Nov 08 2010) ISSN: 1749-8090 [Electronic] England
• PMID: 21059208 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Inosine

Topics

• Animals
• Cardiac Output (drug effects)
• Cardiopulmonary Bypass
• Coronary Circulation (drug effects)
• Dogs
• Heart Arrest, Induced
• Inosine (therapeutic use)
• Myocardial Contraction (drug effects)
• Myocardial Reperfusion Injury (physiopathology, prevention & control)
• Stroke Volume (drug effects)
• Ventricular Function (drug effects)
• Ventricular Pressure (drug effects)