Luo Hong-he
2003
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Quality indicators
Journal
Chinese Journal of Pathophysiology
Abstract
AIM:To study the metabolic pathways of adenosine monophosphate (AMP) in the chronic failing cardiac myocytes of patients with congenital heart disease (CHD). METHODS: Randomized twenty-seven patients with congenital heart disease were involved in this research, with male in 15, female in 12, and mean age (11 9±13 6) years old. Patients were divided into three groups by NewYork Heart Association (NYHA) heart function classification standard. The grade of NYHAⅠwas in group A, with the grade of NYHA Ⅱin group B and the grade of NYHA Ⅲ and Ⅳ in group C. Before cardiopulmonary bypass (CPB) during their heart operations, the heart tissue strips were isolated from the right atrium appendage. The high performance liquid chromatograph was performed for determining the concentration of AMP and its metabolite adenosine (Ado) and inosine monophosphate (IMP). The preoperative ejection fraction (EF) of left ventricle by echocardiogram and heart failure complication post-operation were recorded for the analysis of the relationship with IMP/Ado. RESULTS:There was no significant statistic difference among the contents of AMP in three groups ( P ≥0 05). The concentration of Ado was lower in the group C ( P ≤0 05) and the concentration of IMP was higher significantly ( P ≤0.05). There was a significant increase in the ratio of IMP/Ado in the three groups. Negative relationship was found between pre-operative EF of left ventricle and IMP/Ado (K constant). The higher K constant was, the higher incidence of post-operative heart failure would be. CONCLUSION:The metabolic pathway of AMP in the failing cardiac myocytes of CHD may go along with the way to create more IMP. The lower of pre-operative ejection fraction of left ventricle indicates the abnormal change of AMP catabolism, post-operation heart failure may be an important complication in these patients.