Metabolic Correlates of Myocardial Stunning and the Effect of Cardiopulmonary Bypass

Shukri F. Khuri, Trevor C. Axford, Jose P. Garcia, Kamal R. Khabbaz, Joseph A. Dearani, Igor Khait, Michael Zolkewitz, Nancy A. Healey

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Abstract In order to study the metabolic consequences of myocardial stunning, repeated coronary occlusions were performed in dogs. The production of CO2, adenosine triphosphate (ATP), phosphocreatine (PCr), and inorganic phosphate (Pi) by myocardial cells was assessed, along with extracellular and intracellular pH. Our results indicate that regional coronary artery occlusion reduces the ability of the myocardium to produce H+ and CO2 and to replenish ATP post ischemia. These alterations, then, represent the hallmark of metabolic viability during periods of ischemic insult. Decreases in PCr and Pi were completely eliminated during reperfusion and, therefore, are not reflective of myocardial stunning. When normothermic cardiopulmonary bypass (CPB) is instituted and the coronary artery is occluded three times with reperfusion between each occlusion, alterations in myocardial H+ and high energy phosphates are identical to those observed using only repetitive coronary occlusion. Systemic hypothermia during CPB does not protect against myocardial stunning; however, it is anticipated that interventions that prevent the reduction in H+ and ATP levels may overcome the effects of myocardial stunning that occur during cardiac surgery.

Original languageEnglish (US)
Pages (from-to)262-270
Number of pages9
JournalJournal of cardiac surgery
Issue number2 S
StatePublished - Mar 1993

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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