The effects of intracoronary nicardipine on ventricular dynamics and function in patients undergoing off-pump coronary artery bypass graft surgery.
OBJECTIVE
To evaluate whether intracoronary nicardipine can provide myocardial protection in patients undergoing off-pump coronary artery bypass graft surgery.


METHODS
Clinical trial.


METHODS
Single-institution, academic hospital.


METHODS
Off-pump coronary artery bypass patients with good ejection fraction.


METHODS
Patients were divided into 2 equal groups: group A received 1 mL (0.1 mg) of intracoronary nicardipine before performing the distal anastomosis, and group B patients received 1 mL of NaCl in the coronary artery. Transesophageal echocardiography (PowerVision 6000, 9-mm 6-MHz probe; Toshiba, Elmsford, NY) was used in this study.


RESULTS
Left ventricular ejection fraction, cardiac index, tissue Doppler imaging, velocity of the left ventricle and mitral annulus, and troponin levels were measured in both groups. The incidence of diastolic dysfunction as evaluated by superior pulmonary blood flow and pulsed-wave Doppler of the mitral annulus was significantly lower in group A. Tissue Doppler imaging velocity of the left ventricle and mitral annular displacement were significantly higher in the nicardipine group. Group A patients had significantly lower incidences of ST-segment changes, prolonged pharmacologic support in the postoperative period, and lower levels of troponin after surgery.


CONCLUSIONS
Intracoronary nicardipine improves ventricular function in patients undergoing off-pump coronary artery bypass surgery.
Casthely
Pierre Abdon
PA
Department of Anesthesiology, Seton Hall University, St. Joseph's Regional Medical Center, Paterson, NJ, USA.
Defilippi
Vincent
V
Pakonis
Gregory
G
Bikkina
Mahesh
M
Yoganathan
Thil
T
Komer
Claudia
C
Cornwell
Lorraine
L
D000328:Adult; D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D006801:Humans; D007269:Injections, Intra-Arterial; D008875:Middle Aged; D009529:Nicardipine / Q000008:administration & dosage*; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology*
D009529:Nicardipine