Journal of Chest Surgery

  • 제46권6호
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  • Pages.413-425
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  • 2013
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
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Nafamostat Mesilate: Can It Be Used as a Conduit Preserving Agent in Coronary Artery Bypass Surgery?

  • Yoon, Yoo Sang (Department of Thoracic Surgery, Dongnam Institute of Radiological and Medical Science) ;
  • Oh, Hyunkong (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine) ;
  • Kim, Yonghwan (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine) ;
  • Lim, Seung Pyung (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine) ;
  • Kim, Cuk-Seong (Department of Physiology, Chungnam National University School of Medicine) ;
  • Kang, Min-Woong (Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine)
  • 투고 : 2013.07.15
  • 심사 : 2013.08.05
  • 발행 : 2013.12.05
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초록

Background: Graft vessel preservation solution in coronary artery bypass surgery is used to maintain the graft conduit in optimal condition during the perioperative period. Nafamostat mesilate (NM) has anticoagulation and anti-inflammatory properties. Therefore, we investigated NM as a conduit preservative agent and compared it to papaverine. Methods: Sprague-Dawley (SD) rat thoracic aortas were examined for their contraction-relaxation ability using phenylephrine (PE) and acetylcholine (ACh) following preincubation with papaverine and NM in standard classical organ baths. Human umbilical vein endothelial cells (HUVECs) were cultured to check for the endothelial cell viability. Histopathological examination and terminal deoxynucleotidyl transferase dUTP nick end labeling assay were performed on the thoracic aortas of SD rats. Results: The anti-contraction effects of papaverine were superior to those of NM at PE (p<0.05). The relaxation effect of NM on ACh-induced vasodilatation was not statistically different from that of papaverine. Viability assays using HUVECs showed endothelial cell survival rates of >90% in various concentrations of both NM and papaverine. A histopathological study showed a protective effect against necrosis and apoptosis (p<0.05) in the NM group. Conclusion: NM exhibited good vascular relaxation and a reasonable anti-vasocontraction effect with a better cell protecting effect than papaverine; therefore, we concluded that NM is a good potential conduit preserving agent.

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참고문헌

  1. Rihal CS, Raco DL, Gersh BJ, Yusuf S. Indications for coronary artery bypass surgery and percutaneous coronary intervention in chronic stable angina: review of the evidence and methodological considerations. Circulation 2003;108: 2439-45. https://doi.org/10.1161/01.CIR.0000094405.21583.7C
  2. Eagle KA, Guyton RA, Davidoff R, et al. ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery). Circulation 2004;110:e340- 437.
  3. Coronary Revascularization Writing Group, Patel MR, Dehmer GJ, et al. ACCF/SCAI/STS/AATS/AHA/ASNC/HFSA/ SCCT 2012 appropriate use criteria for coronary revascularization focused update: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, American Society of Nuclear Cardiology, and the Society of Cardiovascular Computed Tomography. J Thorac Cardiovasc Surg 2012;143:780-803. https://doi.org/10.1016/j.jtcvs.2012.01.061
  4. Raja SG, Haider Z, Ahmad M, Zaman H. Saphenous vein grafts: to use or not to use? Heart Lung Circ 2004;13:150-6. https://doi.org/10.1016/j.hlc.2004.03.013
  5. Tsakok M, Montgomery-Taylor S, Tsakok T. Storage of saphenous vein grafts prior to coronary artery bypass grafting: is autologous whole blood more effective than saline in preserving graft function? Interact Cardiovasc Thorac Surg 2012;15:720-5. https://doi.org/10.1093/icvts/ivs275
  6. Santoli E, Di Mattia D, Boldorini R, Mingoli A, Tosoni A, Santoli C. University of Wisconsin solution and human saphenous vein graft preservation: preliminary anatomic report. Eur J Cardiothorac Surg 1993;7:548-52. https://doi.org/10.1016/1010-7940(93)90055-G
  7. Shinn SH, Kim YH, Seo JK, et al. In vitro effects of nitroglycerin, nicardipine, verapamil, and papaverine on rabbit brachial and celiac arterial tone. Korean J Thorac Cardiovasc Surg 2008;41:541-9.
  8. Parker PE, Bashour FA, Downey HF, Boutros IS. Coronary reperfusion: effects of vasodilators (papaverine and adenosine). Am Heart J 1977;93:66-72. https://doi.org/10.1016/S0002-8703(77)80173-7
  9. Mirkhani H, Shafa M, Khazraei H. Comparison of the effects of levosimendan and papaverine on human internal mammary artery and saphenous vein. Cardiovasc Drugs Ther 2009;23:355-9. https://doi.org/10.1007/s10557-009-6197-0
  10. Harrison WE, Mellor AJ, Clark J, Singer DR. Vasodilator pre-treatment of human radial arteries; comparison of effects of phenoxybenzamine vs papaverine on norepinephrine-induced contraction in vitro. Eur Heart J 2001;22:2209-16. https://doi.org/10.1053/euhj.2001.2629
  11. Mussa S, Guzik TJ, Black E, Dipp MA, Channon KM, Taggart DP. Comparative efficacies and durations of action of phenoxybenzamine, verapamil/nitroglycerin solution, and papaverine as topical antispasmodics for radial artery coronary bypass grafting. J Thorac Cardiovasc Surg 2003;126: 1798-805. https://doi.org/10.1016/S0022-5223(03)00943-7
  12. Wilson RF, White CW. Intracoronary papaverine: an ideal coronary vasodilator for studies of the coronary circulation in conscious humans. Circulation 1986;73:444-51. https://doi.org/10.1161/01.CIR.73.3.444
  13. Gao YJ, Yang H, Teoh K, Lee RM. Detrimental effects of papaverine on the human internal thoracic artery. J Thorac Cardiovasc Surg 2003;126:179-85. https://doi.org/10.1016/S0022-5223(03)00040-0
  14. Hitomi Y, Ikari N, Fujii S. Inhibitory effect of a new synthetic protease inhibitor (FUT-175) on the coagulation system. Haemostasis 1985;15:164-8.
  15. Schetz M. Anticoagulation for continuous renal replacement therapy. Curr Opin Anaesthesiol 2001;14:143-9. https://doi.org/10.1097/00001503-200104000-00004
  16. Iwaki M, Ino Y, Motoyoshi A, et al. Pharmacological studies of FUT-175, nafamostat mesilate. V. Effects on the pancreatic enzymes and experimental acute pancreatitis in rats. Jpn J Pharmacol 1986;41:155-62. https://doi.org/10.1254/jjp.41.155
  17. Akizawa T, Koshikawa S, Ota K, Kazama M, Mimura N, Hirasawa Y. Nafamostat mesilate: a regional anticoagulant for hemodialysis in patients at high risk for bleeding. Nephron 1993;64:376-81. https://doi.org/10.1159/000187357
  18. Murase M, Usui A, Tomita Y, Maeda M, Koyama T, Abe T. Nafamostat mesilate reduces blood loss during open heart surgery. Circulation 1993;88(5 Pt 2):II432-6.
  19. Han SJ, Kim HS, Kim KI, et al. Use of nafamostat mesilate as an anticoagulant during extracorporeal membrane oxygenation. J Korean Med Sci 2011;26:945-50. https://doi.org/10.3346/jkms.2011.26.7.945
  20. Noguchi S, Nakatsuka M, Konishi H, Kamada Y, Chekir C, Kudo T. Nafamostat mesilate suppresses NF-kappaB activation and NO overproduction in LPS-treated macrophages. Int Immunopharmacol 2003;3:1335-44. https://doi.org/10.1016/S1567-5769(03)00146-2
  21. Nakatsuka M, Asagiri K, Noguchi S, Habara T, Kudo T. Nafamostat mesilate, a serine protease inhibitor, suppresses lipopolysaccharide-induced nitric oxide synthesis and apoptosis in cultured human trophoblasts. Life Sci 2000;67: 1243-50. https://doi.org/10.1016/S0024-3205(00)00716-5
  22. Bhoola KD, Figueroa CD, Worthy K. Bioregulation of kinins: kallikreins, kininogens, and kininases. Pharmacol Rev 1992;44:1-80.
  23. Iwama H, Nakane M, Ohmori S, et al. Nafamostat mesilate, a kallikrein inhibitor, prevents pain on injection with propofol. Br J Anaesth 1998;81:963-4. https://doi.org/10.1093/bja/81.6.963
  24. Ryu HG, Jung CW, Lee CS, Lee J. Nafamostat mesilate attenuates Postreperfusion Syndrome during liver transplantation. Am J Transplant 2011;11:977-83. https://doi.org/10.1111/j.1600-6143.2011.03514.x
  25. Cavallari N, Abebe W, Mingoli A, et al. Functional and morphological evaluation of canine veins following preservation in different storage media. J Surg Res 1997;68:106-15. https://doi.org/10.1006/jsre.1996.4981
  26. He GW, Yang CQ. Use of verapamil and nitroglycerin solution in preparation of radial artery for coronary grafting. Ann Thorac Surg 1996;61:610-4. https://doi.org/10.1016/0003-4975(95)00920-5
  27. Martin W, Furchgott RF, Villani GM, Jothianandan D. Phosphodiesterase inhibitors induce endothelium-dependent relaxation of rat and rabbit aorta by potentiating the effects of spontaneously released endothelium-derived relaxing factor. J Pharmacol Exp Ther 1986;237:539-47.
  28. Brading AF, Burdyga TV, Scripnyuk ZD. The effects of papaverine on the electrical and mechanical activity of the guinea-pig ureter. J Physiol 1983;334:79-89. https://doi.org/10.1113/jphysiol.1983.sp014481
  29. Kato H, Inoue M, Yamamura Y, et al. Mechanism of polymorphonuclear leukocytes accumulation examined using inhibitors of complement and arachidonic acid cascade in rats treated with OK-432. Nat Immun Cell Growth Regul 1989;8:290-300.
  30. Tamura K, Manabe T, Imanishi K, et al. Effect of synthetic protease inhibitors on superoxide (O2-), hydrogen peroxide (H2O2) and hydroxyl radical production by human polymorphonuclear leukocytes. Hepatogastroenterology 1992;39: 59-61.

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