Metabolic Cardioprotection by Pyruvate: Recent Progress

 

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MINIREVIEW

Robert T. Mallet*1,
Jie Sun*,
E. Marty Knott*,
Arti B. Sharma* and
Albert H. Olivencia-Yurvati

^* Departments of Integrative Physiology and Surgery, University of North Texas Health Science Center, Fort Worth, Texas 76107–2699

¹ Department of Integrative Physiology, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107–2699. E-mail: malletr{at}hsc.unt.edu

Pyruvate, a natural metabolic fuel and antioxidant in myocardium and other tissues, exerts a variety of cardioprotective actions when provided at supraphysiological concentrations. Pyruvate increases cardiac contractile performance and myocardial energy state, bolsters endogenous antioxidant systems, and protects myocardium from ischemia-reperfusion injury and oxidant stress. This article reviews and discusses basic and clinically oriented research conducted over the last several years that has yielded fundamental information on pyruvate’s inotropic and cardioprotective mechanisms. Particular attention is placed on pyruvate’s enhancement of sarcoplasmic reticular Ca²⁺ transport, its antioxidantproperties, and its ability to mitigate reversible and irreversiblemyocardial injury. These research efforts are establishing theessential foundation for clinical application of pyruvate therapyin numerous settings including cardiopulmonary bypass surgery,cardiopulmonary resuscitation, myocardial stunning, and cardiacfailure.

Keywords: antioxidant, bypass surgery, cardiac stunning, cardiopulmonary resuscitation, ethyl pyruvate, infarction, myocardial ischemia, phosphorylation potential, reactive oxygen species

This work was supported by grants from the National Heart, Lungand Blood Institute (HL-71684) and the Osteopathic HeritageFoundation (OHF 02-18-522). E.M.K. and A.B.S. were supportedby fellowships from the University of North Texas Health ScienceCenter Graduate School of Biomedical Sciences.

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