Calcium-Channel Blockers Preserve Coronary Endothelial Reactivity After Ischemia- Reperfusion François Dagenais, MD, Raymond Cartier, MD, Charleen Hollmann,

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Presentation transcript:

Calcium-Channel Blockers Preserve Coronary Endothelial Reactivity After Ischemia- Reperfusion François Dagenais, MD, Raymond Cartier, MD, Charleen Hollmann, RN, Josie Buluran, BS The Annals of Thoracic Surgery Volume 63, Issue 4, Pages 1050-1056 (April 1997) DOI: 10.1016/S0003-4975(96)01278-7

Fig. 1 Experimental protocol. (CCB = calcium-channel blocker; 5-HT = 5-hydroxytryptamine; SNP = sodium nitroprusside.) The Annals of Thoracic Surgery 1997 63, 1050-1056DOI: (10.1016/S0003-4975(96)01278-7)

Fig. 2 Effects of preischemic infusion of the calcium-channel blockers nifedipine (hatched bars), verapamil (white bars), and diltiazem (black bars) on coronary basal flow (CBF), left ventricular pressure (LVP), and the first derivative of left ventricular pressure (dP/dt). Concentrations used were 10−9 to 10−6 mol/L for each of the calcium antagonists. (Dunnet’s analysis of variance: ∗p < 0.05 referred to subgroup of each drug compared with control group and †p < 0.005 referred to in-between group differences for each concentration.) The Annals of Thoracic Surgery 1997 63, 1050-1056DOI: (10.1016/S0003-4975(96)01278-7)

Fig. 3 Effects of nifedipine, verapamil, and diltiazem perfusion (arrow indicates perfusion start) on left ventricular pressure (LVP), first derivative of left ventricular pressure (dP/dt), mean coronary flow, and pulsatile coronary flow at the 10−7 mol/L concentration. Recordings show a significant increase in mean and pulsatile coronary flow with all calcium-channel blockers; the maximal flow increase was obtained with nifedipine. The decrease in left ventricular pressure and dP/dt was maximal with verapamil and minimal with diltiazem. The Annals of Thoracic Surgery 1997 63, 1050-1056DOI: (10.1016/S0003-4975(96)01278-7)

Fig. 4 This figure represents an example of real-time value of coronary flow increase to 5-hydroxytryptamine before (right) and after ischemia-reperfusion (left) at a concentration of 10−9 mol/L. As illustrated, nifedipine and verapamil better preserved endothelium-dependent relaxation than diltiazem at that concentration. The Annals of Thoracic Surgery 1997 63, 1050-1056DOI: (10.1016/S0003-4975(96)01278-7)

Fig. 5 Percentage of preservation of preischemic value of endothelium-dependent coronary flow increase to 5-hydroxytryptamine for all groups pretreated with the calcium antagonists nifedipine, verapamil, and diltiazem compared with control. Concentrations used were 10−9 to 10−6 mol/L for each calcium-channel blocker. (Dunnet’s variance analysis.) The Annals of Thoracic Surgery 1997 63, 1050-1056DOI: (10.1016/S0003-4975(96)01278-7)

Fig. 6 Percentage of preservation of preischemic value of endothelium-dependent coronary flow increase to 5-hydroxytryptamine for all groups pretreated with the calcium antagonists nifedipine, verapamil, and diltiazem. Concentrations used were 10−9 to 10−6 mol/L for each calcium-channel blocker. (Dunnet’s variance analysis.) The Annals of Thoracic Surgery 1997 63, 1050-1056DOI: (10.1016/S0003-4975(96)01278-7)