Suppression of Graft Spasm by the Particulate Guanylyl Cyclase Activator in Coronary Bypass Surgery
Suppression of Graft Spasm by the Particulate Guanylyl Cyclase Activator in Coronary Bypass Surgery
复制标题
冠状动脉搭桥手术中颗粒鸟苷酸环化酶激活剂抑制移植物痉挛
DOI：
10.1016/j.athoracsur.2016.10.003
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发表时间：
2017
影响因子：
4.6
通讯作者：
Okamura T
中科院分区：
文献类型：
--
作者：
Kinoshita T;Tawa M;Suzuki T;Aimi Y;Asai T;Okamura T
动脉移植物痉挛仍是冠状动脉搭桥术中的临床难题。本研究旨在探讨微粒型鸟苷酸环化酶激活剂(卡珀肽)在胸内动脉和胃网膜动脉移植物中的解痉剂作用。方法在器官浴中观察卡必肽对血管紧张剂诱导的预收缩的松弛作用；卡必肽对随后的血管收缩的抑制作用；卡必肽和硝酸甘油对细胞内环鸟苷磷酸水平升高的影响。结果卡必肽对氯化钾、苯肾上腺素、前列腺素F2α或内皮素1的收缩具有浓度依赖性的非内皮依赖性的松弛作用。卡必利的药效和疗效明显高于硝酸甘油和硝苯地平。卡必利可显著减弱血管紧张剂引起的随后收缩。结论卡必利对人胸内动脉和胃网膜动脉移植物的血管收缩有较强的抑制作用。冠脉搭桥术中和术后应用卡必利有利于移植物痉挛的预防和逆转。
BackgroundSpasm of arterial grafts is still a clinical problem in coronary artery bypass surgery. The present study was designed to examine the effect of particulate guanylyl cyclase activator (carperitide) as an antispastic agent in internal thoracic artery and gastroepiploic artery grafts.MethodsIsolated arterial grafts taken during surgery were studied in organ bath in three ways: the relaxing effect of carperitide on vasoconstrictor-induced precontraction; the inhibitory effect of pretreatment with carperitide on subsequent vasoconstrictor-induced contraction; and the effect of carperitide and nitroglycerin on increase of intracellular cyclic guanosine monophosphate levels.ResultsCarperitide produced a concentration-related, endothelium-independent relaxation contracted with potassium chloride, phenylephrine, prostaglandin F2α, or endothelin-1. Carperitide showed significantly higher potency and efficacy than nitroglycerin and nifedipine. Pretreatment with carperitide significantly attenuated the subsequent vasoconstrictor-induced contraction. Carperitide produced more cyclic guanosine monophosphate than nitroglycerin.ConclusionsCarperitide has a potent inhibitory effect on the vasoconstriction mediated by different vasoconstrictors in human internal thoracic artery and gastroepiploic artery grafts. The use of carperitide in patients during and after coronary artery bypass surgery is favored for the prevention and reversal of graft spasm.