Pharmacology of coronary artery bypass grafts

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Presentation transcript:

Pharmacology of coronary artery bypass grafts Franklin L Rosenfeldt, Guo-Wei He, MD, PhD, Brian F Buxton, James A Angus, PhD The Annals of Thoracic Surgery Volume 67, Issue 3, Pages 878-888 (March 1999) DOI: 10.1016/S0003-4975(98)01299-5

Fig 1 Schematic diagram of calcium entry into a smooth muscle cell through receptor-operated (ROC) and voltage-operated (VOC) channels (upper panel). Calcium-entry blocking drugs selectively reduce the open state of VOC. Glyceryl trinitrate (GTN) releases nitric oxide (NO) into the cell, which stimulates guanylate cyclase to raise cyclic guanosine 5′-monophosphate (cGMP) that subsequently leads to Ca2+ being removed from the cell (lower panel). (Em = membrane potential; GTP = guanosine triphosphate; [Ca2+]o = extracellular calcium concentration; TXA2 = thromboxane A2; [Ca2+]; = intracellular calcium concentration. Reprinted from [23] by permission of Circulation 1989;80(Suppl):I-141–50 The Annals of Thoracic Surgery 1999 67, 878-888DOI: (10.1016/S0003-4975(98)01299-5)

Fig 2 Human saphenous veins were treated with either Ringer’s lactate electrolyte solution (Saline), papaverine, or combination glyceryl trinitrate–verapamil (GV) solution during harvesting. After preparation and distention for grafting, endothelial coverage was assessed microscopically and compared with an unprepared undistended segment of vein (Control, 95% confidence limits). Endothelial coverage was greater with GV treatment than with papaverine or no treatment, but there was still substantial loss of endothelium compared with unprepared vein. The Annals of Thoracic Surgery 1999 67, 878-888DOI: (10.1016/S0003-4975(98)01299-5)