Analysis of increased myocardial contractility during sodium acetate infusion in humans.

To analyze the reported effects of acetate on left ventricular (LV) contractility during dialysis, LV function was studied before and after a 20-min sodium acetate (Na Ac) infusion (0.06 mmoles X kg-1 X min-1) in seven patients with heart rate (HR) controlled by atrial pacing. Angiographically determined LV volumes and LV pressures were used to calculate the LV function indices. A plasma acetate concentration of 3.13 +/- 1.05 (SD) mmoles X liter-1 induced an increase in cardiac index from 3.8 +/- 0.6 to 4.4 +/- 0.6 (SD) liter X min-1 X m-2 (P less than 0.01) and a rise in total body O2 consumption from 7.47 +/- 1.28 to 8.67 +/- 1.66 mmoles X min-1 X m-2 (P less than 0.05); there was no alteration of the volume elastic constant, of the end diastolic stress, and of the end systolic stress. There was an increase of the ejection fraction from 0.44 +/- 0.10 to 0.51 +/- 0.09 (P less than 0.01), the maximum velocity of shortening (Vmax, sec-1) from 1.37 +/- 0.25 to 1.55 +/- 0.28 (P less than 0.05), and of the end systolic stress-end systolic volume ratio (g X cm-2 X ml-1) from 2.99 +/- 0.76 to 3.40 +/- 0.98 (P less than 0.01). Hence, the enhancement of these indices was not the consequence of any alteration of HR, preload, or afterload.(ABSTRACT TRUNCATED AT 250 WORDS)