Protective effect of nisoldipine on myocardial ischemia during coronary bypass surgery.
BACKGROUND
Nisoldipine, a calcium antagonist, was assessed for myocardial protection and the prevention of reperfusion injury in patients undergoing CABG.


METHODS
Of the 34 subjects undergoing CABG in this study, 20 were given nisoldipine orally at 10 mg/day for 2 weeks before surgery (N group) and the other 14 untreated controls (C group). Myocardial protection was conducted via ante-grade cold blood cardioplegia at 20-minute intervals.


RESULTS
Myocardial blood flow was significantly higher in the N group (67.8 +/- 21.8 ml/100 g vs. 47.2 +/- 14.4 ml/100 g, p < 0.05) after cardiopulmonary bypass. Serum interleukin-6 levels were significantly lower in the N group 1 hour after reperfusion (116 +/- 58 vs. 409 +/- 362 pg/ml, p < 0.05), as were serum lactate dehydrogenase levels immediately after surgery (888 +/- 268 vs. 1350 +/- 486 IU/L, p < 0.05). The N Group showed a better left ventricle stroke work index 6 hours after surgery (43 +/- 8 vs. 36 +/- 9 g.m/m2). Dopamine dosage in the N group on postoperative day 1 was lower than in controls (5.3 +/- 1.9 vs. 3.0 +/- 2.4 micrograms/kg/min).


CONCLUSIONS
Preoperative nisoldipine treatment increased blood flow in the postischemic myocardium and prevented myocardial damage and reperfusion injury to some extent.
Usui
A
A
Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.
Kawamura
M
M
Murakami
F
F
Oshima
H
H
Yoshida
K
K
Hibi
M
M
Nakayama
R
R
D000284:Administration, Oral; D000368:Aged; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000517:prevention & control*; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D015737:Nisoldipine / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care
D002121:Calcium Channel Blockers; D015737:Nisoldipine