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Engin E, Alp Yildirim Fİ, Kalelі Durman D, Ömeroğlu SN, Göksedef D, Teskіn Ö, Balkanay OO, İpek G, Uydeş Doğan BS. Relaxant effect of the prostacyclin analogue iloprost on isolated human radial artery: An approach for the reversal of graft spasm. Prostaglandins Other Lipid Mediat 2017; 133:35-41. [PMID: 29107024 DOI: 10.1016/j.prostaglandins.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 10/10/2017] [Accepted: 10/17/2017] [Indexed: 10/18/2022]
Abstract
Radial artery graft spasm in the perioperative or postoperative period of coronary bypass surgery necessitates urgent treatment due to risk of graft failure and mortality. Herein, we evaluated the effect of iloprost, a prostacyclin (PGI2) analogue, against the contractions produced by noradrenaline and potassium chloride on isolated human radial artery. Following the determination of endothelial and vascular relaxing capacities of the arteries, iloprost (10-9M-10-6M) was cumulatively applied on rings precontracted submaximally with the spasmogens. In some rings, the response to iloprost was assessed following pretreatment with nitric oxide (NO) synthase inhibitor, l-NAME (3×10-4M,30min). Iloprost produced complete relaxations on radial artery rings precontracted with noradrenaline whereas, only moderate relaxations against the contractions induced by potassium chloride. Notably, the relaxation to iloprost was remarkably blunted in radial arteries with impaired endothelial function. Moreover, the relaxation to iloprost was unchanged in rings pretreated with l-NAME. Our results demonstrated that iloprost could be a potent relaxant agent in reversing radial artery spasm, particularly initiated by noradrenaline, possibly acting via an endothelium-mediated mechanism unrelated to NO.
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Affiliation(s)
- Ersoy Engin
- Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, Istanbul, Turkey; Department of Cardiovascular Surgery, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey
| | - F İlkay Alp Yildirim
- Department of Pharmacology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - Deniz Kalelі Durman
- Department of Pharmacology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
| | - Suat Nail Ömeroğlu
- Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Deniz Göksedef
- Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Önder Teskіn
- Biruni University, Faculty of Medicine, Department of Cardiovascular Surgery, Istanbul, Turkey
| | - Ozan Onur Balkanay
- Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Gökhan İpek
- Department of Cardiovascular Surgery, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - B Sönmez Uydeş Doğan
- Department of Pharmacology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey.
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Ertuna E, Turkseven S, Amanvermez D, Ayik F, Yagdi T, Yasa M. Effects of levosimendan on isolated human internal mammary artery and saphenous vein: concurrent use with conventional vasodilators. Fundam Clin Pharmacol 2016; 30:226-34. [PMID: 26839979 DOI: 10.1111/fcp.12185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 01/22/2016] [Accepted: 01/29/2016] [Indexed: 11/30/2022]
Abstract
Graft spasm is a common problem in coronary artery bypass grafting (CABG). In this study, we aimed to investigate the interaction of levosimendan, a novel inodilator, with vasodilator agents that are clinically used for the treatment of graft spasm and with endogenous vasoconstrictors that are thought to play a role in graft vasospasm, in human internal mammary artery (IMA) and saphenous vein (SV). Isolated human IMA and SV segments derived from patients undergoing CABG were suspended in an organ bath. Responses to cumulative concentrations of noradrenaline (NA), serotonin (5-HT), papaverine, nitroglycerin (NG), and diltiazem were recorded before and after 10(-5) m levosimendan incubation (30 min). In addition, cumulative levosimendan responses were taken in vessels precontracted with NA or 5-HT. 10(-5) m levosimendan reduced NA Emax and sensitivity in IMA and SV, and 5-HT Emax responses in IMA. Moreover, levosimendan caused concentration-dependent relaxation in both grafts. Papaverine Emax or sensitivity was not altered by levosimendan neither in IMA nor in SV. Levosimendan diminished NG sensitivity in IMA and Emax responses in SV and decreased diltiazem Emax responses both in IMA and SV. Our results suggest that levosimendan may be used alone for prevention or treatment of graft spasm in IMA or in combination with papaverine in IMA and SV grafts. However, as concurrent administration with diltiazem or NG causes a reduction in relaxation in vitro, we suggest caution should be exercised when using levosimendan in combination with these agents.
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Affiliation(s)
- Elif Ertuna
- Department of Pharmacology, Faculty of Pharmacy, Ege University, Bornova-Izmir, 35100, Turkey
| | - Saadet Turkseven
- Department of Pharmacology, Faculty of Pharmacy, Ege University, Bornova-Izmir, 35100, Turkey
| | - Dilsad Amanvermez
- Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, Bornova-Izmir, 35100, Turkey
| | - Fatih Ayik
- Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, Bornova-Izmir, 35100, Turkey
| | - Tahir Yagdi
- Department of Cardiovascular Surgery, Faculty of Medicine, Ege University, Bornova-Izmir, 35100, Turkey
| | - Mukadder Yasa
- Department of Pharmacology, Faculty of Pharmacy, Ege University, Bornova-Izmir, 35100, Turkey
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Technical Issues in the Use of the Radial Artery as a Coronary Artery Bypass Conduit. Ann Thorac Surg 2014; 98:2247-54. [DOI: 10.1016/j.athoracsur.2014.07.039] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/06/2014] [Accepted: 07/09/2014] [Indexed: 11/20/2022]
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