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Comparison of myocardial protection with nifedipine and potassium.

Publication ,  Journal Article
Magee, PG; Flaherty, JT; Bixler, TJ; Glower, D; Gardner, TJ; Bukley, BH; Gott, VL
Published in: Circulation
August 1979

Nifedipine, a slow-channel calcium blocker, is thought to provide useful myocardial protection during prolonged total ischemia and reperfusion. An isolated, isovolumic, feline heart model was used to asses the effectiveness of nifedipine in both cardioplegic (100 microgram/10 ml) and noncardioplegic (10 microgram/10 ml) doses for providing myocardial preservation during 90 minutes of hypothermic ischemic arrest and 45 minutes of normothermic reperfusion. Use of nifedipine was compared to hypothermia (27 degrees C) alone and to hypothermia with potassium cardioplegia. Ventricular function was assessed by recovery of isovolumic left ventricular developed pressure and dP/dt. Myocardial carbon dioxide tension (PCO2) and myocardial oxygen tension (PO2) were measured by mass spectrometry. Potassium cardioplegia and the higher dose of nifedipine resulted in immediate asystole. The rates of rise of PCO were greatest in the group receiving 10 microgram nifedipine and in the control group. The rates of rise in the two cardioplegic groups were significantly lower. Recovery of ventricular function was significantly lower with low-dose nifedipine than with potassium cardioplegia. Higher dose nifedipine resulted in a return of function, which was no different than with potassium cardioplegia. Morphologic protection was better with higher dose nifedipine and potassium cardioplegia than with either low-dose cardioplegia or hypothermia alone. These results demonstrate that nifedipine in a cardioplegic dose results in preservation of myocardial structure and function that is similar to that obtained with potassium cardioplegia. In lower noncardioplegic dose, nifedipine does not appear to offer additional protection compared to hypothermia alone. Whether persistent depression of ventricular contractility will limit nifedipine's clinical usefulness as a myocardial protection agent will require further study.

Duke Scholars

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

August 1979

Volume

60

Issue

2 Pt 2

Start / End Page

151 / 157

Location

United States

Related Subject Headings

  • Time Factors
  • Pyridines
  • Potassium
  • Oxygen Consumption
  • Oxygen
  • Organ Size
  • Nifedipine
  • Myofibrils
  • Myocardium
  • Myocardial Contraction
 

Citation

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Magee, P. G., Flaherty, J. T., Bixler, T. J., Glower, D., Gardner, T. J., Bukley, B. H., & Gott, V. L. (1979). Comparison of myocardial protection with nifedipine and potassium. Circulation, 60(2 Pt 2), 151–157. https://doi.org/10.1161/01.cir.60.2.151
Magee, P. G., J. T. Flaherty, T. J. Bixler, D. Glower, T. J. Gardner, B. H. Bukley, and V. L. Gott. “Comparison of myocardial protection with nifedipine and potassium.Circulation 60, no. 2 Pt 2 (August 1979): 151–57. https://doi.org/10.1161/01.cir.60.2.151.
Magee PG, Flaherty JT, Bixler TJ, Glower D, Gardner TJ, Bukley BH, et al. Comparison of myocardial protection with nifedipine and potassium. Circulation. 1979 Aug;60(2 Pt 2):151–7.
Magee, P. G., et al. “Comparison of myocardial protection with nifedipine and potassium.Circulation, vol. 60, no. 2 Pt 2, Aug. 1979, pp. 151–57. Pubmed, doi:10.1161/01.cir.60.2.151.
Magee PG, Flaherty JT, Bixler TJ, Glower D, Gardner TJ, Bukley BH, Gott VL. Comparison of myocardial protection with nifedipine and potassium. Circulation. 1979 Aug;60(2 Pt 2):151–157.

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

August 1979

Volume

60

Issue

2 Pt 2

Start / End Page

151 / 157

Location

United States

Related Subject Headings

  • Time Factors
  • Pyridines
  • Potassium
  • Oxygen Consumption
  • Oxygen
  • Organ Size
  • Nifedipine
  • Myofibrils
  • Myocardium
  • Myocardial Contraction