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In the subsequent randomized trial, 16 pigs underwent cardiac magnetic resonance imaging 4 weeks after a myocardial infarction, then were randomized to either the ISO\/ADE (n\u2009=\u20098) or the control (n\u2009=\u20098) group before undergoing cardiac surgery with 1\u2009h recovery. Feasibility and safety end points included the method of ISO\/ADE delivery, serial blood pressure, heart rate, pH, HCO3-, circulating lactate levels, troponin levels and arrhythmias. Biomarkers of efficacy included serial lactate levels and serial pO2 mean arterial-to-venous functional ratio along with histologic levels of glycogen, protein carbonyls, O2, CO2, HCO3- and fibrosis. Postoperative rates of low cardiac output and death were also recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Cardiac magnetic resonance measures of myocardial infarction did not differ between the groups. The selected method of ISO\/ADE delivery was feasible. At no time were all safety outcomes measured in the ISO\/ADE group worse than those in the control group. ISO\/ADE reduced circulating lactate levels, preserved the serial pO2 mean arterial-to-venous functional ratio and reduced tissue-based glycogen and protein carbonylation. No other differences were observed. Low cardiac output and death occurred in 3\/8 (37.5%) and 2\/8 (25%) control animals versus 0% in the ISO\/ADE group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The therapy was feasible and safe and improved biomarkers of efficacy. ISO\/ADE was not associated with any postoperative low cardiac output and deaths versus 37.5% and 25%, respectively, in the control group. A pilot human study is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf120","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T08:19:22Z","timestamp":1743668362000},"source":"Crossref","is-referenced-by-count":0,"title":["Preoperative consecutive treatment with isoprenaline and adenosine is safe and reduces ischaemia-reperfusion injury in a porcine model of cardiac surgery with recent acute myocardial infarction"],"prefix":"10.1093","volume":"67","author":[{"given":"Sarah","family":"Smith","sequence":"first","affiliation":[{"name":"Medical School, Faculty of Health and Life Science, University of Bristol , Bristol,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Khaliulin","sequence":"additional","affiliation":[{"name":"Medical School, Faculty of Health and Life Science, University of Bristol , 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