HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Jacob Gurevitch Rephael Mohr Vladimir Yakirevich Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gurevitch, J. Articles by Yakirevich, V. Search for Related Content PubMed PubMed Citation Articles by Gurevitch, J. Articles by Yakirevich, V.

Ann Thorac Surg 1997;63:627-633
© 1997 The Society of Thoracic Surgeons

---

Original Article: Cardiovascular

Captopril in Cardioplegia and Reperfusion: Protective Effects on the Ischemic Heart

Department of Thoracic and Cardiovascular Surgery, Elias Sourasky–Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel

Accepted for publication July 31, 1996.

Background. Previous studies have shown that long-term treatment with the angiotensin-converting enzyme inhibitor captopril attenuates left ventricular dilatation and improves survival after extensive myocardial infarction. However, there is only sparse evidence of the immediate effects of the drug on hearts undergoing global ischemia and reperfusion. The purpose of this study was to investigate the direct effect of captopril, given in cardioplegia or after ischemia, on the functional recovery of the reperfused myocardium.

Methods. Isolated rat hearts undergoing warm cardioplegic arrest followed by 1 hour of global ischemia and 30 minutes of reperfusion were studied using the modified Langendorff model.

Results. After ischemia, hearts receiving captopril (360 µmol/L) either in the cardioplegic solution (n = 9) or during reperfusion (n = 9) developed higher pressure (p < 0.001), greater first derivative of the rise in left ventricular pressure (p < 0.01 and p < 0.001, respectively), greater first derivative of the fall in left ventricular pressure (p < 0.001 and p < 0.002), higher pressure-time integral (p < 0.001), greater coronary flow (p < 0.001), and higher oxygen consumption values (p < 0.001 and p < 0.003) compared with the control group (n = 9). Hearts receiving captopril both in the cardioplegia and during reperfusion (n = 9) had the best recovery of all three groups and lower levels of creatine kinase (47.8 ± 5.9 U/L versus 73.3 ± 5.6 U/L; p < 0.01) compared with the control group.

Conclusions. Captopril given in cardioplegia and in reperfusion has a favorable, protective, and additive effect on the recovery of isolated rat hearts undergoing global ischemia and reperfusion; hemodynamic performance improves, coronary flow and oxygen consumption increase, and myocardial damage decreases.

This article has been cited by other articles:

				H. L. Lazar Role of Angiotensin-Converting Enzyme Inhibitors in the Coronary Artery Bypass Patient Ann. Thorac. Surg., March 1, 2005; 79(3): 1081 - 1089. [Abstract] [Full Text] [PDF]

				B. K. Podesser, J. Schirnhofer, O. Y. Bernecker, A. Kroner, M. Franz, S. Semsroth, B. Fellner, J. Neumuller, S. Hallstrom, and E. Wolner Optimizing Ischemia/Reperfusion in the Failing Rat Heart--Improved Myocardial Protection With Acute ACE Inhibition Circulation, September 24, 2002; 106(12_suppl_1): I-277 - I-283. [Abstract] [Full Text] [PDF]

				P. Korn, A. Kroner, J. Schirnhofer, S. Hallstrom, O. Bernecker, R. Mallinger, M. Franz, H. Gasser, E. Wolner, and B. K. Podesser Quinaprilat during cardioplegic arrest in the rabbit to prevent ischemia-reperfusion injury J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 352 - 360. [Abstract] [Full Text] [PDF]

				T. Yasuda, H. Kamiya, Y. Tanaka, and G. Watanabe Ultra-short-acting cardioselective beta-blockade attenuates postischemic cardiac dysfunction in the isolated rat heart Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 647 - 652. [Abstract] [Full Text] [PDF]

				I. Frolkis, J. Gurevitch, Y. Yuhas, A. Iaina, Y. Wollman, T. Chernichovski, Y. Paz, M. Matsa, D. Pevni, A. Kramer, et al. Interaction between paracrine tumor necrosis factor-alpha and paracrine angiotensin II during myocardial ischemia J. Am. Coll. Cardiol., January 1, 2001; 37(1): 316 - 322. [Abstract] [Full Text] [PDF]

				S. Fischer, A. A. MacLean, M. Liu, B. Kalirai, and S. Keshavjee Inhibition of angiotensin-converting enzyme by captopril: A novel approach to reduce ischemia-reperfusion injury after lung transplantation J. Thorac. Cardiovasc. Surg., September 1, 2000; 120(3): 573 - 580. [Abstract] [Full Text] [PDF]

				D. Talmor, A. Applebaum, A. Rudich, Y. Shapira, and A. Tirosh Activation of Mitogen-Activated Protein Kinases in Human Heart During Cardiopulmonary Bypass Circ. Res., May 12, 2000; 86(9): 1004 - 1007. [Abstract] [Full Text] [PDF]

				S. Greenberg, G. Chemin, I. Shapira, J. George, Y. Wollman, S. Laniado, and G. Keren Captopril and L-Arginine Have a Synergistic Cardioprotective Effect in Ischemic-Reperfusion Injury in the Isolated Rat Heart Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 2000; 5(4): 281 - 290. [Abstract] [PDF]

				H. L. Lazar, C. Volpe, Y. Bao, S. Rivers, J. A. Vita, and J. F. Keaney Jr Beneficial effects of angiotensin-converting enzyme inhibitors during acute revascularization Ann. Thorac. Surg., August 1, 1998; 66(2): 487 - 492. [Abstract] [Full Text] [PDF]

				Y. Paz, J. Gurevitch, I. Frolkis, M. Matsa, A. Kramer, C. Locker, R. Mohr, and G. Keren Effects of an Angiotensin II Antagonist on Ischemic and Nonischemic Isolated Rat Hearts Ann. Thorac. Surg., February 1, 1998; 65(2): 474 - 479. [Abstract] [Full Text] [PDF]