Myocardial preservation in acute coronary artery occlusion with coronary sinus retroperfusion and carnitine.

BACKGROUND: Effectiveness of retrograde coronary sinus perfusion with the use of carnitine supplementation over the severity of ischemia/reperfusion injury, in acute coronary occlusion. METHODS: Eighteen mongrel dogs, divided equally into control, retrograde perfusion (retroperfusion) and carnitine retroperfusion (retrocarnitine) groups. After taking the basal values, the left anterior descending artery was occluded. At the fifteenth minute, without ending the occlusion, retrograde coronary sinus cardioplegia in the retroinfusion group and in the carnitine group, 0.15 mmol/kg of L-carnitine retroperfusion was performed. Then, hemodynamic and biochemical measurements were taken till the end of 120 minutes. The control group had no retroperfusion or medical therapy. RESULTS: Between the three groups, there was a statistically significant difference in cardiac index, mean arterial pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, right atrial pressure as hemodynamic parameters and myocardial oxygen extraction, myocardial Lactate extraction, protein thiols and Malonyl dialdehyde (MBA) as biochemical parameters, at different time intervals (p<0.05). CONCLUSION: Coronary sinus retroperfusion with carnitine is found to be very effective in reducing oxygen free radical release and however this advantage did not switch to the hemodynamic function between the retrograde coronary sinus infusion group and retroinfusion carnitine group. In our opinion retrograde coronary sinus perfusion with the use of carnitine supplementation reduces the severity of ischemia/reperfusion injury.