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Effects of different cardioplegic solutions on nitric oxide release from coronary vasculature in diabetic patients undergoing coronary artery bypass surgery [Anatol J Cardiol]
Anatol J Cardiol. 2006; 6(4): 347-351

Effects of different cardioplegic solutions on nitric oxide release from coronary vasculature in diabetic patients undergoing coronary artery bypass surgery

Pelin Karaca1, Nurgül Yurtseven2, Yavuz Enç3, Tamer Aksoy4, Onur Sokullu5, Fuat Bilgen5, Sevim Canik2
1Department of Cardiovascular Anesthesia, Anadolu Health Center, izmit, Turkey
2Department of Cardiovascular Anesthesia Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center istanbul, Turkey
3Department of Cardiovascular Surgery Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center istanbul, Turkey
4Florence Nightingale Hastanesi, Anesteziyoloji Bölümü, İstanbul
5Dr. Siyami Ersek Göğüs, Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi İstanbul, Türkiye
6Department of Cardiovascular Anesthesia Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center istanbul, Turkey

Objective: The aim of this study was to compare the effects of two different cardioplegic solutions on nitric oxide (NO) release from coro- nary vasculature in patients with type II diabetes mellitus undergoing coronary artery bypass grafting (CABG) surgery. Methods: Forty patients undergoing elective CABG surgery were randomized to be given crystalloid (Group 1 ) or blood (Group 2) cardiople- gia. Aortic and coronary sinus blood samples were taken at three different time periods and the release of NO from the coronary vascula- ture was determined by measuring its stable end-products, nitrite and nitrate. The difference between the aortic and coronary sinus con- centrations of nitrite and nitrate represents the amount of NO released by coronary vascular bed. Results: Before application of aortic cross-clamp, at T1 period, the levels of nitrite/nitrate from the coronary vasculature were similar in both groups (6.53±1.21 μM vs 6.07±1.24 μM, p> 0.05). However after the removal of cross-clamp, a significant decrease in NO was observed in Group 1 as compared with Group 2 (4.21±0.73 μM vs 4.92±1.02 μM, p< 0.01). This decrease persisted at T3 period, after 30 minutes of reper- fusion in group 1 being significantly different from group 2 (3.86±0.49 vs 4.37±0.72 μM, p<0.05). Conclusion: This study has shown that in patients with type II diabetes mellitus crystalloid cardioplegia causes a decrease in the release of NO from coronary vascular bed during aortic cross-clamp and reperfusion period whereas more physiologic blood cardioplegia did not. Our findingsindicatethatbloodcardioplegiaprotectsendothelialfunctionbetterthancrystalloidcardioplegiaindiabeticpatients.

Keywords: Diabetes mellitus, cardiopulmonary bypass, nitric oxide


Pelin Karaca, Nurgül Yurtseven, Yavuz Enç, Tamer Aksoy, Onur Sokullu, Fuat Bilgen, Sevim Canik. Effects of different cardioplegic solutions on nitric oxide release from coronary vasculature in diabetic patients undergoing coronary artery bypass surgery. Anatol J Cardiol. 2006; 6(4): 347-351


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