Oz M. Shapira, MDa, Aiming Xu, PhDb, Joseph A. Vita, MDb, Gabriel S

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Nitroglycerin is superior to diltiazem as a coronary bypass conduit vasodilator Oz M. Shapira, MDa, Aiming Xu, PhDb, Joseph A. Vita, MDb, Gabriel S. Aldea, MDa, Nirav Shah, MDb, Richard J. Shemin, MDa, John F. Keaney, MDb The Journal of Thoracic and Cardiovascular Surgery Volume 117, Issue 5, Pages 906-911 (May 1999) DOI: 10.1016/S0022-5223(99)70370-3 Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 1 Effect of nitroglycerin and diltiazem on radial artery (A), internal thoracic artery (B), and saphenous vein (C). Segments of radial artery, internal thoracic artery, and saphenous vein obtained from the same patients and contracted with 0.1 to 1 μmol/L U46619. Relaxation was recorded in response to the indicated doses of nitroglycerin and diltiazem as described in the text. Data are expressed as mean ± SEM and represent complete vessel sets derived from 11 patients. *P < .001. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 906-911DOI: (10.1016/S0022-5223(99)70370-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 2 Prevention of radial artery vasospasm. A, Radial artery segments were exposed to the indicated concentrations of U46619 in organ chambers containing PSS alone (○), 0.1 μmol/L nitroglycerin (▴), or 1 μmol/L diltiazem (▿). Response to a maximal dose of U46619 was similar for all. B, However, the EC50 of the vasoconstrictor response to U46619 was significantly higher for nitroglycerin. Data are expressed as mean ± SEM and represent data obtained from 6 patients. *P = .046 versus control. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 906-911DOI: (10.1016/S0022-5223(99)70370-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 3 Effect of intravenous nitroglycerin and diltiazem on radial artery vasodilation and blood pressure (BP). Diltiazem (●) or nitroglycerin (□) was given intravenously at the indicated rates in 10 subjects. Vasodilation (A) and blood pressure (B) were recorded as described in the text. *P = .001 for dose-response by one-way repeated measures ANOVA. †P = .03 vs diltiazem by two-way ANOVA. The Journal of Thoracic and Cardiovascular Surgery 1999 117, 906-911DOI: (10.1016/S0022-5223(99)70370-3) Copyright © 1999 Mosby, Inc. Terms and Conditions

Fig. 4 Representative two-dimensional ultrasound images of the radial artery in a volunteer subject exposed to intravenous infusion of nitroglycerin and diltiazem. A 31% increase in radial artery diameter is observed after nitroglycerin infusion (upper panels), whereas diltiazem had no measurable effect (lower panels). The Journal of Thoracic and Cardiovascular Surgery 1999 117, 906-911DOI: (10.1016/S0022-5223(99)70370-3) Copyright © 1999 Mosby, Inc. Terms and Conditions