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Functional effects of phosphoenolpyruvate and ATP on pig hearts in cardioplegia and during reperfusion. An in vivo study with cardiopulmonary bypass.

The effects of phosphoenolpyruvate (PEP) and ATP in cardioplegia and during early reperfusion were studied in pigs. Twenty pigs divided into three groups were placed on cardiopulmonary bypass and subjected to 2 h of hypothermic cardioplegic arrest. Group I (n = 7) served as a control. In group II (n = 7) PEP (14.4 mM) and ATP (0.067 mM) were added to the cardioplegic solution. Group III (n = 6) was given PEP (28.8 mM) and ATP (0.134 mM) with 500 ml of isotonic NaCl in the aortic root during early reperfusion. All animals in group III were weaned from bypass compared with 6 of 7 in group I and 5 of 7 in group II. Forty minutes after ischemia group III was assessed to be the only group with an unchanged aortic flow and stroke volume. The total peripheral resistance and arterial pressure were reduced in this group. The results demonstrate that PEP and ATP administered during reperfusion have a beneficial effect and that this may be exerted both on the myocardium and on the peripheral vessels.