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Zhang YQ, Liu XG, Ding Q, Berguson M, Morris RJ, Liu H, Goldhammer JE. Perioperative Renin-Angiotensin System Inhibitors Improve Major Outcomes of Heart Failure Patients Undergoing Cardiac Surgery: A Propensity-Adjusted Cohort Study. Ann Surg 2023; 277:e948-e954. [PMID: 35166263 DOI: 10.1097/sla.0000000000005408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to study the association of perioperative administration of renin angiotensin system inhibitors (RASi) and clinical outcomes of patients with heart failure (HF) undergoing cardiac surgery. SUMMARY BACKGROUND DATA It is controversial whether the perioperative RASi should be administered in HF patients undergoing cardiac surgery. METHODS A total of 2338 patients with HF and undergoing CABG and/or valve surgeries at multiple hospitals from 2001 to 2015 were identified from STS database. After adjustment using propensity score and instrumental variable, logistic regression was conducted to analyze the influence of preoperative continuation of RASi (PreRASi) on short-term in-hospital outcomes. Independent risk factors of 30-day mortality, major adverse cardiovascular events (MACE), and renal failure were analyzed by use of stepwise logistic regression. The effects of pre- and postoperative use of RASi (PostRASi) on long-term mortality were analyzed using survival analyses. Stepwise Cox regression was conducted to analyze the independent risk factors of 6-year mortality. The relationships of HF status and surgery type with perioperative RASi, as well as PreRASi-PostRASi, were also evaluated by subgroup analyses. RESULTS PreRASi was associated with lower incidences of 30-day mortality [ P < 0.0001, odds ratio (OR): 0.556, 95% confidence interval (CI) 0.405-0.763], stroke ( P =0.035, OR: 0.585, 95% CI: 0.355-0.962), renal failure ( P =0.007, OR: 0.663, 95% CI: 0.493-0.894). Both PreRASi ( P =0.0137) and PostRASi ( P =0.007) reduced 6-year mortality compared with the No-RASi groups. CONCLUSIONS Pre- and postoperative use of RASi was associated with better outcomes for the patients who have HF and undergo CABG and/or valve surgeries. Preoperative continuation and postoperative restoration are warranted in these patients.
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Affiliation(s)
- Yan-Qing Zhang
- Department of Anesthesiology, School of Anesthesiology, The First Hospital, Shanxi Medical University, Taiyuan, China
- Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Xiao-Gang Liu
- The Key Laboratory of Biomedical information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qian Ding
- Department of Anesthesiology, Tangdu Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Mark Berguson
- Department of Anesthesiology, Lankenau Medical Center, Wynnewood, PA
| | - Rohinton J Morris
- Division of Cardiothoracic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Hong Liu
- Department of Anesthesiology, University of California Davis Medical Center, Sacramento, CA
| | - Jordan E Goldhammer
- Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
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Ladak SS, McQueen LW, Layton GR, Aujla H, Adebayo A, Zakkar M. The Role of Endothelial Cells in the Onset, Development and Modulation of Vein Graft Disease. Cells 2022; 11:3066. [PMID: 36231026 PMCID: PMC9561968 DOI: 10.3390/cells11193066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 01/23/2023] Open
Abstract
Endothelial cells comprise the intimal layer of the vasculature, playing a crucial role in facilitating and regulating aspects such nutrient transport, vascular homeostasis, and inflammatory response. Given the importance of these cells in maintaining a healthy haemodynamic environment, dysfunction of the endothelium is central to a host of vascular diseases and is a key predictor of cardiovascular risk. Of note, endothelial dysfunction is believed to be a key driver for vein graft disease-a pathology in which vein grafts utilised in coronary artery bypass graft surgery develop intimal hyperplasia and accelerated atherosclerosis, resulting in poor long-term patency rates. Activation and denudation of the endothelium following surgical trauma and implantation of the graft encourage a host of immune, inflammatory, and cellular differentiation responses that risk driving the graft to failure. This review aims to provide an overview of the current working knowledge regarding the role of endothelial cells in the onset, development, and modulation of vein graft disease, as well as addressing current surgical and medical management approaches which aim to beneficially modulate endothelial function and improve patient outcomes.
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Affiliation(s)
| | | | | | | | | | - Mustafa Zakkar
- Department of Cardiovascular Sciences, Clinical Science Wing, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UK
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3
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Cao DY, Giani JF, Veiras LC, Bernstein EA, Okwan-Duodu D, Ahmed F, Bresee C, Tourtellotte WG, Karumanchi SA, Bernstein KE, Khan Z. An ACE inhibitor reduces bactericidal activity of human neutrophils in vitro and impairs mouse neutrophil activity in vivo. Sci Transl Med 2021; 13:13/604/eabj2138. [PMID: 34321319 PMCID: PMC10370421 DOI: 10.1126/scitranslmed.abj2138] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022]
Abstract
Angiotensin-converting enzyme inhibitors (ACEIs) are used by millions of patients to treat hypertension, diabetic kidney disease, and heart failure. However, these patients are often at increased risk of infection. To evaluate the impact of ACEIs on immune responses to infection, we compared the effect of an ACEI versus an angiotensin receptor blocker (ARB) on neutrophil antibacterial activity. ACEI exposure reduced the ability of murine neutrophils to kill methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, and Klebsiella pneumoniae in vitro. In vivo, ACEI-treated mice infected with MRSA had increased bacteremia and tissue bacteria counts compared to mice treated with an ARB or with no drug. Similarly, ACEIs, but not ARBs, increased the incidence of MRSA-induced infective endocarditis in mice with aortic valve injury. Neutrophils from ACE knockout (KO) mice or mice treated with an ACEI produced less leukotriene B4 (LTB4) upon stimulation with MRSA or lipopolysaccharide, whereas neutrophils overexpressing ACE produced more LTB4 compared to wild-type neutrophils. As a result of reduced LTB4 production, ACE KO neutrophils showed decreased survival signaling and increased apoptosis. In contrast, neutrophils overexpressing ACE had an enhanced survival phenotype. Last, in a cohort of human volunteers receiving the ACEI ramipril for 1 week, ACEI administration reduced neutrophil superoxide and reactive oxygen species production and neutrophils isolated from volunteers during ramipril treatment had reduced bactericidal activity. Together, these data demonstrate that ACEI treatment, but not ARB treatment, can reduce the bacterial killing ability of neutrophils.
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Affiliation(s)
- Duo-Yao Cao
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Jorge F Giani
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA.,Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Luciana C Veiras
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Ellen A Bernstein
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Derick Okwan-Duodu
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA.,Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Faizan Ahmed
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Catherine Bresee
- Biostatistics and Bioinformatics Core, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Warren G Tourtellotte
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA.,Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA.,Department of Neurology, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - S Ananth Karumanchi
- Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Kenneth E Bernstein
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA.,Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
| | - Zakir Khan
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA. .,Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, USA
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Canning P, Doherty G, Tawfick W, Cîndea CN, Hynes N, Sultan S. Analysing the Society for Vascular Surgery and American Association for Vascular Surgery scoring systems for outcomes post-endovascular aortic repair. Ir J Med Sci 2019; 189:1005-1013. [PMID: 31863290 DOI: 10.1007/s11845-019-02160-y] [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: 09/01/2019] [Accepted: 12/02/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Assess the association between the Society for Vascular Surgery/American Association for Vascular Surgery (SVS/AVSS) (Rutherford et al., J Vasc Surg 26: 517-38, 1997; Chaikof et al., J Vasc Surg 35:1061-6, 2002) medical comorbidity scoring scheme (MCS), and the global scoring system (GS) and major morbidity and mortality after elective endovascular aneurysm repair. Primary end points were peri-operative morbidity and mortality. Secondary end points were intensive care unit admission, high dependency unit admission, total stay > 5 days and 2-year mortality. METHODS The project was approved by the Galway Clinical Research Ethics Committee. This project followed the Declaration of Helsinki. Binary logistic regression was performed to assess the association of the scores and their individual components with the primary and secondary outcomes. Results were reported as odds ratio (OR) per point increase in score with 95% confidence intervals (CI) and the Hosmer-Lemeshow (HL). RESULTS Between 2002 and 2015, 401 patients underwent elective EVARs. MCS was calculated for 396 patients while GS was calculated for 183 patients. The MCS (OR 1.906, CI 1.017-3.574, p = 0.044) was associated with perioperative morbidity. The MCS was associated with perioperative mortality (OR 8.875, CI 1.918-41.070, p = 0.005). The GS was associated with perioperative morbidity (OR 11.929, CI 1.151-123.584, p = .038) but not associated with perioperative mortality (OR 3.62, CI 0.006-2118.148, p = .692). CONCLUSIONS The MCS shows association with perioperative morbidity and mortality. GS shows association with perioperative morbidity but not perioperative mortality; however, this may be due to our study being underpowered. We believe that the analysis of higher numbers of patients could unmask trends in both of these scores and individual components of both scores changed.
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Affiliation(s)
| | - Grace Doherty
- Department of Vascular & Endovascular Surgery, University College Hospital, Galway, Ireland
| | - Wael Tawfick
- National University of Ireland, Galway, Ireland.,Department of Vascular & Endovascular Surgery, University College Hospital, Galway, Ireland.,Western Vascular Institute, University College Hospital, Galway, Ireland
| | - Cosmin-Nicodim Cîndea
- Department of Vascular & Endovascular Surgery, University College Hospital, Galway, Ireland
| | - Niamh Hynes
- Department of Vascular & Endovascular Surgery, University College Hospital, Galway, Ireland.,Galway Clinic, Royal College of Surgeons of Ireland, Galway, Ireland
| | - Sherif Sultan
- National University of Ireland, Galway, Ireland.,Department of Vascular & Endovascular Surgery, University College Hospital, Galway, Ireland.,Western Vascular Institute, University College Hospital, Galway, Ireland.,Galway Clinic, Royal College of Surgeons of Ireland, Galway, Ireland
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Perioperative use of renin-angiotensin system inhibitors and outcomes in patients undergoing cardiac surgery. Nat Commun 2019; 10:4202. [PMID: 31519895 PMCID: PMC6744557 DOI: 10.1038/s41467-019-11678-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/24/2019] [Indexed: 12/28/2022] Open
Abstract
It remains disputable about perioperative use of renin-angiotensin system inhibitors (RASi) and their outcome effects. This multicenter retrospective cohort study examines association between use of perioperative RASi and outcomes in patients undergoing coronary artery bypass graft and/or valve surgery. After the exclusion, the patients are divided into 2 groups with or without preoperative RASi (PreRASi, n = 8581), or 2 groups with or without postoperative RASi (PostRASi, n = 8130). With using of propensity scores matching to reduce treatment selection bias, the study shows that PreRASi is associated with a significant reduction in postoperative 30-day mortality compared with without one (3.41% vs. 5.02%); PostRASi is associated with reduced long-term mortality rate compared with without one (6.62% vs. 7.70% at 2-year; 17.09% vs. 19.95% at 6-year). The results suggest that perioperative use of RASi has a significant benefit for the postoperative and long-term survival among patients undergoing cardiac surgery. Renin-angiotensin system inhibitors (RASi) are beneficial in several classes of cardiovascular patients. However, whether their perioperative use is beneficial and/or safe in cardiac surgery is unclear. Here the authors perform a multicenter retrospective cohort study showing that preoperative and postoperative use of RASi is associated with reduction of mortality in patients undergoing cardiac surgery.
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Hassani E, Mahoori A, Karami N, Hassani A, Hassani L. The Effect of Chronic Consumption of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Antagonists on Blood Pressure and Inotrope Consumption After Separation from Cardiopulmonary Bypass. Anesth Pain Med 2018; 8:e74026. [PMID: 30214887 PMCID: PMC6119230 DOI: 10.5812/aapm.74026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 05/28/2018] [Accepted: 06/02/2018] [Indexed: 01/13/2023] Open
Abstract
Background Chronic use of renin-angiotensin system (RAS) antagonists (angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor antagonists (ARAS)) can cause hypotension during anesthesia. In some studies hemodynamic instability, including hypotension and its effects on the clinical outcome in patients treated with these drugs during coronary artery bypass graft (CABG) and need to excessive vasoactive drugs in these patient population, has been described. The aim of this study was to evaluate the effect of chronic consumption of ACEIs and ARAS on blood pressure and inotrope consumption during coronary artery bypass graft under cardiopulmonary bypass. Methods A total of 200 patients undergoing coronary artery bypass graft surgery, who were treated with either ARAS or ACEIs (n = 100) over at least 2 months, or who were not treated with any RAS antagonists (control group, n = 100) were enrolled. The mean arterial blood pressure, central venous pressure, and need for vasoactive drugs, were measured after induction of anesthesia (T1) before cardiopulmonary bypass (T2) and after separation from (CPB), (T3). Results There were no significant differences regarding the mean arterial pressure (case group: T1: 84 ± 7 mmHg, T2: 77 ± 6 mmHg, T3: 83 ± 8 mmHg), (control group: T1: 85 ± 7 mmHg, T2: 81 ± 7 mmHg, T3:84 ± 6 mmHg) between two groups (P > 0.05). Also there were no significant differences regarding mean central venous pressure, mean heart rate, and vasoactive drug consumption between the two groups during the time of intervals. Conclusions We found that preoperative (RAS) antagonist’s continuation have not profound hemodynamic changes during coronary artery bypass graft under cardiopulmonary bypass and so we conclude that omitting these drugs before surgery did not have a sufficient advantage to be recommended routinely.
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Affiliation(s)
- Ebrahim Hassani
- Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran
| | - Alireza Mahoori
- Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran
| | - Nazli Karami
- Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran
- Corresponding author: Nazli Karami, Imam Khomeini Teaching Hospital, Ershad St, Urmia, Iran. Tel/Fax: +98-4433468967, E-mail:
| | - Asma Hassani
- Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran
| | - Leila Hassani
- Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran
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Renin-angiotensin system blockers in cardiac surgery. J Crit Care 2015; 30:613-8. [DOI: 10.1016/j.jcrc.2015.02.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 02/13/2015] [Accepted: 02/23/2015] [Indexed: 11/22/2022]
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8
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Mudumbai SC, Takemoto S, Cason BA, Au S, Upadhyay A, Wallace AW. Thirty-day mortality risk associated with the postoperative nonresumption of angiotensin-converting enzyme inhibitors: a retrospective study of the Veterans Affairs Healthcare System. J Hosp Med 2014; 9:289-96. [PMID: 24799360 DOI: 10.1002/jhm.2182] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 02/04/2014] [Accepted: 02/13/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Angiotensin-converting enzyme inhibitors (ACE-Is) are a widely used class of cardiovascular medication. However, limited data exist on the risks of postoperative nonresumption of an ACE-I. OBJECTIVE To evaluate the factors and 30-day mortality risks associated with the postoperative nonresumption of an ACE-I. DESIGN A retrospective cohort study. SETTING Veterans Affairs (VA) Healthcare System. PATIENTS A total of 294,505 admissions in 240,978 patients with multiple preoperative prescription refills (>3) for an ACE-I who underwent inpatient surgery from calendar years 1999 to 2012. INTERVENTION None. MEASUREMENTS We classified surgical admissions based upon the timing of postoperative resumption of an ACE-I prescription from the day of surgery through postoperative days 0 to 14 and 15 to 30, and collected 30-day mortality data. We evaluated the relationship between 30-day mortality and the nonresumption of an ACE-I from postoperative day 0 to 14 using proportional hazard regression models, adjusting for patient- and hospital-level risk factors. Sensitivity analyses were conducted using more homogeneous subpopulations and propensity score models. RESULTS Twenty-five percent of our cohort did not resume an ACE-I during the 14 days following surgery. Nonresumption of an ACE-I within postoperative day 0 to 14 was independently associated with increased 30-day mortality (hazard ratio: 3.44; 95% confidence interval: 3.30-3.60; P < 0.001) compared to the restart group. Sensitivity analyses maintained this relationship. CONCLUSIONS Nonresumption of an ACE-I is common after major inpatient surgery in the large VA Health Care System. Restarting of an ACE-I within postoperative day 0 to 14 is, however, associated with decreased 30-day mortality. Careful attention to the issue of timely reinstitution of chronic medications such as an ACE-I is indicated.
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Affiliation(s)
- Seshadri C Mudumbai
- Anesthesia Service, Veterans Affairs Palo Alto Health Care System, Palo Alto and Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University, Stanford, California
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Kim JH, Kim H, Kim YH, Chung WS, Suh JK, Kim SJ. Antioxidant effect of captopril and enalapril on reactive oxygen species-induced endothelial dysfunction in the rabbit abdominal aorta. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2013; 46:14-21. [PMID: 23422724 PMCID: PMC3573160 DOI: 10.5090/kjtcs.2013.46.1.14] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 09/06/2012] [Accepted: 09/20/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Reactive oxygen species (ROS) are known to be related to cardiovascular diseases. Many studies have demonstrated that angiotensin-converting enzyme inhibitors have beneficial effects against ROS. We investigated the antioxidant effect of captopril and enalapril in nitric oxide mediated vascular endothelium-dependent relaxations. MATERIALS AND METHODS Isolated rabbit abdominal aorta ring segments were exposed to ROS by electrolysis of the organ bath medium (Krebs-Henseleit solution) after pretreatment with various concentrations (range, 10(-5) to 3×10(-4) M) of captopril and enalapril. Before and after electrolysis, the endothelial function was measured by preconstricting the vessels with norepinephrine (10(-6) M) followed by the cumulative addition of acetylcholine (range, 3×10(-8) to 10(-6) M). The relevance of the superoxide anion and hydrogen peroxide scavenging effect of captopril and enalapril was investigated using additional pretreatments of diethyldithiocarbamate (DETCA, 0.5 mM), an inhibitor of Cu/Zn superoxide dismutase, and 3-amino-1,2,4-triazole (3AT, 50 mM), an inhibitor of catalase. RESULTS Both captopril and enalapril preserved vascular endothelium-dependent relaxation after exposure to ROS in a dose-dependent manner (p<0.0001). Pretreatment with DETCA attenuated the antioxidant effect of captopril and enalapril (p<0.0001), but pretreatment with 3AT did not have an effect. CONCLUSION Both captopril and enalapril protect endothelium against ROS in a dose-dependent fashion in isolated rabbit abdominal aortas. This protective effect is related to superoxide anion scavenging.
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Affiliation(s)
- Ji Hoon Kim
- Department of Medicine, Sicho Subcenter, Seocheon County Public Health Center, Korea
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Renal dysfunction and CABG. Curr Opin Pharmacol 2012; 12:181-8. [DOI: 10.1016/j.coph.2012.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 01/30/2012] [Accepted: 02/23/2012] [Indexed: 12/27/2022]
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