HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Minxin Wei Pekka Kuukasjärvi Jari Laurikka Otso Järvinen Matti Tarkka Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wang, X. Articles by Tarkka, M. Search for Related Content PubMed PubMed Citation Articles by Wang, X. Articles by Tarkka, M. Related Collections Cardiac - pharmacology Coronary disease

Eur J Cardiothorac Surg 2003;24:967-973
© 2003 Elsevier Science NL

Novel pharmacological preconditioning with diazoxide attenuates myocardial stunning in coronary artery bypass grafting

^a Division of Cardiothoracic Surgery, Tampere University Hospital, Tampere, Finland
^b Department of Anesthesia and Intensive Care, Tampere University Hospital, Tampere, Finland

Received 7 April 2003; received in revised form 17 June 2003; accepted 19 June 2003.

^* Corresponding author. Division of Cardiothoracic Surgery, Tampere University Hospital, P.O. Box 2000, Fin-33521 Tampere, Finland. Tel.: +358-3-2476378; fax: +358-3-2475756
e-mail: matti.tarkka{at}pshp.fi

Objective: To investigate whether novel pharmacological preconditioning with diazoxide could protect the myocardial function and decrease myocardial injury in patients undergoing coronary artery bypass grafting (CABG). Methods: Forty patients with stable angina who were scheduled for isolated elective CABG operations were randomized into control group (n=20) and diazoxide (DZX) group (n=20). In the DZX group, 1.5 mg/kg diazoxide was infused intravenously within 5 min followed by a 5-min washout before commencing the cardiopulmonary bypass (CPB). In the control group, a time-matched period of placebo infusion was given. Hemodynamic data and biochemical markers of myocardial injury were measured perioperatively. Results: There were no adverse effects related to diazoxide. Cardiac index (CI) increased postoperatively as compared with baseline. In the DZX group, the improvement of CI was better than that in the control group (p=0.001). Left and right ventricular stroke work indexes decreased postoperatively, and recovered much faster in the DZX group (p=0.027 and p=0.049, respectively). There were no statistically significant differences in the other hemodynamic parameters. The creatine kinase cardiac isoenzyme (CK-MB) was highest in both groups on the first postoperative day (control 28.8±23.8 and DZX 27.3±19.4, N.S.). The cumulative release of CK-MB postoperatively was lower in the DZX patients as compared with the controls, but the difference remained not significant (p=0.09). Conclusions: Pharmacological preconditioning of the human heart with diazoxide is feasible; it confers additional myocardial protection beyond that provided by the cardioplegia alone by attenuating myocardial stunning after CABG operations.

Key Words: Diazoxide • Pharmacological preconditioning • Coronary artery bypass grafting

This article has been cited by other articles:

				V. Venugopal, A. Ludman, D. M. Yellon, and D. J. Hausenloy 'Conditioning' the heart during surgery Eur. J. Cardiothorac. Surg., June 1, 2009; 35(6): 977 - 987. [Abstract] [Full Text] [PDF]

				M. A. Deja, M. Malinowski, K. S. Golba, M. Kajor, T. Lebda-Wyborny, D. Hudziak, W. Domaradzki, D. Szurlej, A. Bonczyk, J. Biernat, et al. Diazoxide protects myocardial mitochondria, metabolism, and function during cardiac surgery: A double-blind randomized feasibility study of diazoxide-supplemented cardioplegia J. Thorac. Cardiovasc. Surg., April 1, 2009; 137(4): 997 - 1004. [Abstract] [Full Text] [PDF]