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Responsiveness of internal thoracic arteries to nitroglycerin in patients with renal failure

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Abstract

Nitroglycerin is commonly used as an antispasmodic for treating spasm of coronary artery bypass grafts. This study investigated whether the presence of renal failure affects reactivity to nitroglycerin in internal thoracic arteries obtained from patients undergoing coronary bypass surgery. The patients were divided into three groups according to estimated glomerular filtration rate (eGFR, mL/min/1.73 m2): without renal failure (60 ≤ eGFR, n = 13), with moderate renal failure (30 ≤ eGFR < 60, n = 10), and with severe renal failure (eGFR < 30, n = 10). Organ chamber technique was used to evaluate concentration-related responses of isolated internal thoracic arteries to vasodilators. Nitroglycerin induced a concentration-dependent relaxation, which was significantly augmented in patients with severe but not moderate renal failure than in those without renal failure. In addition, there was a negative correlation between eGFR and the relaxant efficacy of nitroglycerin (P = 0.016). On the other hand, relaxant responses to BAY 60-2770 (which enhances cGMP generation as with nitroglycerin) were similar among three grades of renal function. An inverse relationship of eGFR to the relaxant efficacy of BAY 60-2770 was not observed, either (P = 0.314). These findings suggest that severe renal failure specifically potentiates nitroglycerin-induced relaxation in internal thoracic artery grafts.

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Acknowledgements

This work was supported in part by the Smoking Research Foundation and by the Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan (Grant Number 17K15579). The authors wish to thank Dr. Johannes-Peter Stasch (Institute of Cardiovascular Research, Pharma Research Centre, Bayer AG) for the gift of BAY 60-2770.

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  1. Masashi Tawa

    Present address: Department of Pharmacology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan

Authors and Affiliations

  1. Department of Pharmacology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan

    Masashi Tawa & Tomio Okamura

  2. Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan

    Takeshi Kinoshita, Tohru Asai & Tomoaki Suzuki

  3. Department of Pharmacology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan

    Takaharu Ishibashi

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  1. Masashi Tawa
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Correspondence to Masashi Tawa.

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Tawa, M., Kinoshita, T., Asai, T. et al. Responsiveness of internal thoracic arteries to nitroglycerin in patients with renal failure. Heart Vessels 33, 682–687 (2018). https://doi.org/10.1007/s00380-017-1105-1

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