| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1998;66:487-492
© 1998 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
b Section of Cardiology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
Accepted for publication March 28, 1998.
Address reprint requests to Dr Lazar, Department of Cardiothoracic Surgery, Boston Medical Center, B402, 88 E Newton St, Boston, MA 02118
Presented at the Eighty-third Annual Clinical Congress of the American College of Surgeons, Chicago, Illinois, Oct 12–17, 1997.
Background. This experimental study was undertaken to determine whether using angiotensin-converting enzyme inhibitors during surgical revascularization of acutely ischemic myocardium would improve wall motion and limit infarct size.
Methods. Twenty pigs underwent 90 minutes of occlusion of the second and third diagonal arteries followed by 45 minutes of cardioplegic arrest and 180 minutes of reperfusion. In 10 animals, the angiotensin-converting enzyme inhibitor enalaprilat (0.05 mg/kg) was infused intravenously during coronary occlusion; 10 other animals received no angiotensin-converting enzyme inhibitors. Ischemic damage was assessed by the number of cardioversions required for ventricular tachycardia or fibrillation; wall motion scores using echocardiography (4 = normal to -1 = dyskinesia); and infarct size using histochemical staining. Epicardial coronary artery vasomotor function was assessed using standard organ chamber methodology.
Results. Enalaprilat-treated hearts had the least amount of ventricular irritability (0.84 ± 0.24 versus 2.77 ± 0.22 cardioversions; p < 0.01), the best recovery of wall motion score (3.20 ± 0.15 versus 1.52 ± 0.07; p < 0.0001), and the lowest infarct size (22.6% ± 1.4% versus 37.7% ± 3.0%; p < 0.001). Endothelium-independent relaxation was preserved in all hearts; however, endothelium-dependent relaxation was impaired in both groups.
Conclusions. Angiotensin-converting enzyme inhibitors reduce myocardial damage during surgical revascularization of acutely ischemic myocardium.
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
 |
|
 H. L. Lazar, Y. Bao, S. Rivers, T. Colton, and S. A. Bernard High tissue affinity angiotensin-converting enzyme inhibitors improve endothelial function and reduce infarct size Ann. Thorac. Surg., August 1, 2001; 72(2): 548 - 553. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. L. Lazar Angiotensin-converting enzyme inhibitors during acute revascularization Ann. Thorac. Surg., December 1, 1998; 66(6): 2163 - 2163. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
