Impact of myocardial angiotensin-converting enzyme activity on coronary vascular resistance and serum brain natriuretic peptide concentration in coronary bypass surgery.
Angiotensin-converting enzyme (ACE) inhibitors have cardioprotective effects in animals, but whether that occurs in humans is still controversial. The effect of myocardial ACE activity on coronary vascular resistance during coronary artery bypass surgery and on serum brain natriuretic peptide (BNP) concentration after surgery was studied in myocardial tissue sampled from the right atrium of patients during cardiac surgery (n=20). Tissue enzyme activity (nmol/min per mg protein) was measured using a photometric technique, and the flow rate and pressure upon antegrade infusion of a crystalloid cardioplegic solution was measured for calculating the coronary vascular resistance (mmHg. ml(-1). min(-1)). Serum BNP concentration (pg/ml) was measured on days 0 and 5 after the surgery. Linear regression between tissue ACE activity and coronary vascular resistance (y = 0.46x + 0.56, r=0.85) as well as serum BNP concentration on days 0 (y = 129x + 30, r=0.59) and 5 (y = 347x + 180, r=0.73) after the surgery was significant (x: ACE activity; y: coronary vascular resistance/serum BNP concentration). The results indicate that inhibition of myocardial ACE activity might improve coronary circulation during surgery and hence, cardiac function after surgery.
Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kawaramachi, Kyoto, Japan. Yasuyuki.Shimada@ma8.seikyou.ne.jp
Yasuyuki
Y
Shimada
Hitoshi
H
Yaku
Keisuke
K
Shuntoh
Katsuhiko
K
Oka
Takahisa
T
Okano
Tsutomu
T
Matsushita
Atsushi
A
Fukumoto
Kyoko
K
Hayashida
Yoshiaki
Y
Yamada
Taiji
T
Watanabe
Nobuo
N
Kitamura
D000368:Aged; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D007703:Peptidyl-Dipeptidase A / Q000378:metabolism*; D014655:Vascular Resistance / Q000502:physiology*
D020097:Natriuretic Peptide, Brain; D007703:Peptidyl-Dipeptidase A