FRUCTOSE-1,6-DIPHOSPHATE FAILS TO LIMIT EARLY MYOCARDIAL-INFARCTION SIZE IN A CANINE MODEL

Study objective: Fructose-1,6-diphosphate (FDP) appears to improve early post-myocardial infarction hemodynamics and limit early myocardial infarct size in previous canine studies. However, these studies did not account for the effect of collateral blood flow on infarct size. Our objective was to determine the effect of FDP on early infarct size and hemodynamics while measuring regional myocardial blood flow. Design: A prospective, blinded, placebo-controlled laboratory study using a canine open-chest left anterior descending coronary artery (LAD) occlusion model. Interventions: Twenty-two mongrel dogs were assigned randomly to receive either FDP (1 75 mg/kg, then 2 mg/kg/min for two hours) or placebo, beginning five minutes after LAD occlusion. Measurements and main results: Regional myocardial blood flow, hemodynamics, and myocardial infarct size were determined. Infarct size was assessed using magnetic resonance imaging in a subset of animals. Three of the 22 dogs had no infarct and significantly higher collateral blood flow than the 19 animals with myocardial infarction (P<.001). Four hours after LAD occlusion, cardiac index, dP/dt(max), heart rate, and systolic and mean aortic pressures were not statistically different between groups. Infarct size expressed as area of necrosis/area at risk was similar between groups (FDP, 0.55 +/- 0.28; controls, 0.59 +/- 0.31). Conclusion: FDP given after occlusion of the LAD in this canine model did not limit early myocardial infarct size.