Protective effect of nisoldipine on myocardial ischemia during coronary bypass surgery

Background: Nisoldipine, a calcium antagonist, was assessed for myocardial protection and the prevention of reperfusion injury in patients undergoing CABG.Methods: Of the 34 subjects undergoing CABG in this study, 20 were given nisoldipine orally at 10 mg/day for 2 weeks before surgery (N group) and the other 14 untreated controls (C group). Myocardial protection was conducted via antegrade cold blood cardioplegia at 20-minute intervals.Results: Myocardial blood flow was significantly higher in the N group (67.8±21.8 ml/100 g vs. 47.2±14.4 ml/100 g, p < 0.05) after cardiopulmonary bypass. Serum interleukin-6 levels were significantly lower in the N group 1 hour after reperfusion (116±58 vs. 409±362 pg/ml, p < 0.05), as were serum lactate dehydrogenase levels immediately after surgery (888±268 vs. 1350±486 IU/L, p < 0.05). The N Group showed a better left ventricle stroke work index 6 hours after surgery (43±8 vs. 36±9 g·m/m²). Dopamine dosage in the N group on postoperative day 1 was lower than in controls (5.3±1.9 vs. 3.0±2.4 μg/kg/min). Conclusions: Preoperative nisoldipine treatment increased blood flow in the postischemic myocardium and prevented myocardial damage and reperfusion injury to some extent.