[Cardioprotective effects of diltiazem infusion in the perioperative period in patients undergoing coronary artery bypass grafting with extracorporeal circulation].
OBJECTIVE
To evaluate the cardioprotective effects of intravenous diltiazem infusion perioperatively in patients undergoing coronary artery bypass grafting (CABG) under extracorporeal circulation.


METHODS
Forty patients undergoing CABG were divided into 2 groups of 20 patients according to the operation date: experimental group in which infusion of diltiazem (0.1 mg/kg/h) was given starting from the onset of extracorporeal circulation until 24 h after the aortic cross-clamping, and blank control group. The relative hemodynamic parameters were recorded for 48 hours.


RESULTS
(1) 4 approximately 24 hours after the aortic cross-clamping the heart rates of the experimental group was 98 +/- 18 approximately 96 +/- 13 times/min, significantly lower than those of the control group (111 +/- 16 approximately 105 +/- 14 times/min, P<0.05); the values of rate-pressure product (RPP) of the experimental group were 13.0 +/- 3.7 approximately 11.7 +/- 3.0 mm Hg/min/10(3), significantly lower than those of the control group (14.1 +/- 1.9 approximately 5.8 +/- 3.6 approximately mm Hg/min/10(3), P<0.05) (2) The postoperative peak value of creatine kinase (CK) was not significantly different between these 2 groups. The postoperative peak value of creatine kinase-MB (CK-MB) in the experimental group was 83 +/- 33 IU/L, significantly lower than that in the control group (105 +/- 20 IU/L, P<0.05) and postoperative peak value of cardiac troponin-T (cTNT) was 0.38 +/- 0.21 IU/L, significantly lower than that in the control group (0.83 +/- 0.20 IU/L, P<0.05). The values of CK, CK-MB, and cardiac troponin TC (cTNT) of the patients with coronary vasospasm in the experimental group were all significantly lower than those of the patients with coronary vasospasm in the control group. (3) The average number of arrhythmic events per hour was lower in diltiazem group, and the average number of ventricular premature contraction per hour was significantly lower during the period of ST segment depression in particular.


CONCLUSIONS
Perioperative intravenous diltiazem infusion provides significant cardioprotective effect in patients undergoing CABG.
Zhang
Peng
P
Cardiothoracic Department, General Hospital of Tianjin Medical University, Tianjin 300052, China.
Chen
Gang
G
Zhang
Peng
P
Zheng
Kai
K
Wang
Guo-lin
GL
D001145:Arrhythmias, Cardiac / Q000517:prevention & control; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D004110:Diltiazem / Q000008:administration & dosage / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D017202:Myocardial Ischemia / Q000517:prevention & control; D020011:Protective Agents / Q000494:pharmacology*; D020107:Troponin T / Q000097:blood
D007527:Isoenzymes; D020011:Protective Agents; D020107:Troponin T; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D004110:Diltiazem