GLUTAMINE CARDIOPROTECTIVE EFFECTS IN PATIENTS WITH ISCHEMIC HEART DISEASE, OPERATED UNDER CARDIOPULMONARY BYPASS
It was conducted a study of glutamine cardioptotective effects during perioperative use in patients with ischemic heart disease, operated under CB. Exclusion criteria were: left ventricular ejection fraction less than 50%, diabetes melitus, myocardial infarction less than 3 months ago, Patients of the study group (n=25) had glutamine (20% solution N(2)-L-alanine-L-glutamine ("Dipeptiven®" Fresenius Kabi, Germany); 0.4 g/kg/day. Patients of control group (n=25) received placebo (0.9% NaCl solution). The main indicators were the dynamics of troponin I, as well as central hemodynamics parameters. On the 1-st day after operation the concentration of troponin I was significantly lower in the glutamine-group compared placebo-group (1.280 (0.840-2.230) 2.410 (1.060-6.600) ng/ml; p=0.035). 4 hours after CB in a glutamine-group also had significantly large indicators of cardiac index (2.58 (2.34-2.91) l/min/m <sup>2</sup> vs 2.03 (1.76-2.32)) l/min/m <sup>2</sup>; p=0,002) and stroke index (32.8 (27.8-36.0.) ml/m <sup>2</sup> vs 26.1 (22.6-31.8) ml/m <sup>2</sup>; p=0.023). Systemic vascular resistance index was significantly lower in glutamine-group (1942 (1828-2209) dyn-s/cmr <sup>5</sup>/m <sup>2</sup> vs 2456 (2400-3265) dyn-s/cmr <sup>5</sup>/m <sup>2</sup>; р=0.001). Conclusion. Perioperative use of N(2)-L-alanine-L-glutamine during the first 24 hours of perioperative period gives cardioprotective effect in patients with ischemic heart disease operated under CB.