Pre-conditioning with the soluble guanylate cyclase activator Cinaciguat reduces ischaemia-reperfusion injury after cardiopulmonary bypass

Objective: Activation of the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate (NO-sGC-cGMP) pathway can induce potent cardioprotection-like effects against ischaemia-reperfusion injury and nitro-oxidative stress. We investigated the effects of pharmacological pre-conditioning wi...

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Main Authors: Radovits, Tamás (Author) , Korkmaz-İçöz, Sevil (Author) , Miesel-Gröschel, Christiane (Author) , Seidel, Beatrice (Author) , Stasch, Johannes-Peter (Author) , Merkely, Béla (Author) , Karck, Matthias (Author) , Szabó, Gábor (Author)
Format: Article (Journal)
Language:English
Published: 01 February 2011
In: European journal of cardio-thoracic surgery
Year: 2011, Volume: 39, Issue: 2, Pages: 248-255
ISSN:1873-734X
DOI:10.1016/j.ejcts.2010.05.025
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ejcts.2010.05.025
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Author Notes:Tamás Radovits, Sevil Korkmaz, Christiane Miesel-Gröschel, Beatrice Seidel, Johannes-Peter Stasch, Béla Merkely, Matthias Karck, Gábor Szabó

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520 |a Objective: Activation of the nitric oxide-soluble guanylate cyclase-cyclic guanosine monophosphate (NO-sGC-cGMP) pathway can induce potent cardioprotection-like effects against ischaemia-reperfusion injury and nitro-oxidative stress. We investigated the effects of pharmacological pre-conditioning with Cinaciguat (BAY 58-2667), a novel sGC activator on peroxynitrite-induced endothelial dysfunction in vitro, as well as on myocardial and coronary vascular function during reperfusion in a canine model of cardioplegic arrest and extracorporeal circulation. Methods: Isolated coronary arterial rings exposed to peroxynitrite were investigated for vasomotor function. Vehicle- and Cinaciguat-pre-treated (8.33 μg h−1 or 25 μg h−1 intravenous (IV) for 30 min) anaesthetised dogs (n = 6-7 per group) underwent hypothermic cardiopulmonary bypass with 60 min of hypothermic cardioplegic arrest. Left- and right-ventricular end-systolic pressure-volume relationship (ESPVR) was measured by a pressure-volume conductance catheter at baseline and after 60 min of reperfusion. Coronary blood flow, vasodilatation to acetylcholine and myocardial level of adenosine triphosphate were determined. Results: Pre-incubation of coronary rings with Cinaciguat improved peroxynitrite-induced endothelial dysfunction. Compared with control, pharmacological pre-conditioning with Cinaciguat (25 μg h−1) led to higher myocardial adenosine triphosphate content, to a better recovery of left- and right-ventricular contractility (Δ slope of left ventricular ESPVR given as percent of baseline: 102.4 ± 19.1% vs 56.0 ± 7.1%) and to a higher coronary blood flow (49.6 ± 3.5 ml min−1 vs 28.0 ± 3.9 ml min−1). Endothelium-dependent vasodilatation to acetylcholine was improved in the treatment groups. Conclusions: Pre-conditioning with Cinaciguat improves myocardial and endothelial function after cardiopulmonary bypass with hypothermic cardiac arrest. The observed protective effects imply that pharmacological sGC activation could be a novel therapeutic option in the protection against ischaemia-reperfusion injury in cardiac surgery. 
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