Short-term low dose intracoronary diltiazem administered at the onset of reperfusion reduces myocardial infarct size

William Raymond Herzog, Robert A. Vogel, Matthew L. Schlossberg, Lisa R. Edenbaum, Helen J. Scott, Victor L. Serebruany

Research output: Contribution to journalArticle

Abstract

Background: Currently, controversy exists regarding the use of calcium-channel blockers in the treatment of acute myocardial infarction (AMI), due to apparent conflicting results from clinical trials and animal models. One hypothesis to explain such a discrepancy proposes that the timing and duration of drug administration might influence its cardioprotective effect. Pretreatment with calcium-channel blockers or their administration during coronary artery occlusion in associated with the diminished infarct size in animal models. While verapamil failed to reduce infarct size when the drug was given at the onset of reperfusion, similar effects of low dose diltiazem are not known. Methods and Results: This experiment evaluated the effect of intracoronary short term low dose diltiazem administration given immediately with postischemic myocardial reperfusion. Yorkshire swine underwent thoracotomy and 50 min of left anterior descending (LAD) occlusion, followed by 3 h of reperfusion. In the first group, diltimem (2.5 mg diluted in 60 cc saline) was infused into the LAD over 12 min, beginning with the onset of reperfusion (n=8). In the second group, animals received saline instead of diltiazem and served as controls (n=6). Infarct size was 0.13±0.06 g/kg of body weight for diltiazem group, and 0.42±0.04 g/kg for controls (P=0.01). Conclusions: Short-term low dose diltiazem delivered exclusively during early reperfusion can significantly diminish infarct size in swine. Local intracoronary diltiazem may be valuable adjunct in patients subject to myocardial ischemia/reperfusion during coronary artery bypass grafting, primary angioplasty for AMI, or thrombolysis for AMI if given immediately after restoration of coronary blood flow.

Original languageEnglish (US)
Pages (from-to)21-27
Number of pages7
JournalInternational Journal of Cardiology
Volume59
Issue number1
DOIs
StatePublished - Mar 1 1997
Externally publishedYes

Fingerprint

Diltiazem
Reperfusion
Myocardial Infarction
Myocardial Reperfusion
Calcium Channel Blockers
Swine
Animal Models
Coronary Occlusion
Thoracotomy
Verapamil
Angioplasty
Coronary Artery Bypass
Pharmaceutical Preparations
Myocardial Ischemia
Coronary Vessels
Body Weight
Clinical Trials

Keywords

  • Animal model
  • Calcium channel blockers
  • Diltiazem
  • Myocardial infarction
  • Reperfusion injury

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Short-term low dose intracoronary diltiazem administered at the onset of reperfusion reduces myocardial infarct size. / Herzog, William Raymond; Vogel, Robert A.; Schlossberg, Matthew L.; Edenbaum, Lisa R.; Scott, Helen J.; Serebruany, Victor L.

In: International Journal of Cardiology, Vol. 59, No. 1, 01.03.1997, p. 21-27.

Research output: Contribution to journalArticle

Herzog, William Raymond ; Vogel, Robert A. ; Schlossberg, Matthew L. ; Edenbaum, Lisa R. ; Scott, Helen J. ; Serebruany, Victor L. / Short-term low dose intracoronary diltiazem administered at the onset of reperfusion reduces myocardial infarct size. In: International Journal of Cardiology. 1997 ; Vol. 59, No. 1. pp. 21-27.
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abstract = "Background: Currently, controversy exists regarding the use of calcium-channel blockers in the treatment of acute myocardial infarction (AMI), due to apparent conflicting results from clinical trials and animal models. One hypothesis to explain such a discrepancy proposes that the timing and duration of drug administration might influence its cardioprotective effect. Pretreatment with calcium-channel blockers or their administration during coronary artery occlusion in associated with the diminished infarct size in animal models. While verapamil failed to reduce infarct size when the drug was given at the onset of reperfusion, similar effects of low dose diltiazem are not known. Methods and Results: This experiment evaluated the effect of intracoronary short term low dose diltiazem administration given immediately with postischemic myocardial reperfusion. Yorkshire swine underwent thoracotomy and 50 min of left anterior descending (LAD) occlusion, followed by 3 h of reperfusion. In the first group, diltimem (2.5 mg diluted in 60 cc saline) was infused into the LAD over 12 min, beginning with the onset of reperfusion (n=8). In the second group, animals received saline instead of diltiazem and served as controls (n=6). Infarct size was 0.13±0.06 g/kg of body weight for diltiazem group, and 0.42±0.04 g/kg for controls (P=0.01). Conclusions: Short-term low dose diltiazem delivered exclusively during early reperfusion can significantly diminish infarct size in swine. Local intracoronary diltiazem may be valuable adjunct in patients subject to myocardial ischemia/reperfusion during coronary artery bypass grafting, primary angioplasty for AMI, or thrombolysis for AMI if given immediately after restoration of coronary blood flow.",
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T1 - Short-term low dose intracoronary diltiazem administered at the onset of reperfusion reduces myocardial infarct size

AU - Herzog, William Raymond

AU - Vogel, Robert A.

AU - Schlossberg, Matthew L.

AU - Edenbaum, Lisa R.

AU - Scott, Helen J.

AU - Serebruany, Victor L.

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AB - Background: Currently, controversy exists regarding the use of calcium-channel blockers in the treatment of acute myocardial infarction (AMI), due to apparent conflicting results from clinical trials and animal models. One hypothesis to explain such a discrepancy proposes that the timing and duration of drug administration might influence its cardioprotective effect. Pretreatment with calcium-channel blockers or their administration during coronary artery occlusion in associated with the diminished infarct size in animal models. While verapamil failed to reduce infarct size when the drug was given at the onset of reperfusion, similar effects of low dose diltiazem are not known. Methods and Results: This experiment evaluated the effect of intracoronary short term low dose diltiazem administration given immediately with postischemic myocardial reperfusion. Yorkshire swine underwent thoracotomy and 50 min of left anterior descending (LAD) occlusion, followed by 3 h of reperfusion. In the first group, diltimem (2.5 mg diluted in 60 cc saline) was infused into the LAD over 12 min, beginning with the onset of reperfusion (n=8). In the second group, animals received saline instead of diltiazem and served as controls (n=6). Infarct size was 0.13±0.06 g/kg of body weight for diltiazem group, and 0.42±0.04 g/kg for controls (P=0.01). Conclusions: Short-term low dose diltiazem delivered exclusively during early reperfusion can significantly diminish infarct size in swine. Local intracoronary diltiazem may be valuable adjunct in patients subject to myocardial ischemia/reperfusion during coronary artery bypass grafting, primary angioplasty for AMI, or thrombolysis for AMI if given immediately after restoration of coronary blood flow.

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