ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Comparison of the effect of nebivolol, metoprolol and diltiazem on tissue nitric oxide synthase activity in internal mammary artery
Vedat Bakuy1, Mete Gürsoy1, Zeynep Levent Çıraklı2, Cabir Gulmaliyev1, Mehmet Atay1, Ahmet Akgül1
Department of Cardiovascular Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
1Departments of Cardiovascular Surgery Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
2Departments of Biochemistry, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2014.9415
Background: This study aims to evaluate the effects of nebivolol on nitric oxide synthase activity in human internal mammary artery compared to metoprolol and diltiazem.

Methods: Seventy-five patients (43 males, 32 females; mean age 61.6±5.8 years; range 41 to 76 years) who were scheduled f or c oronary a rtery b ypass g rafting w ere enrolled in this study. Patients were assigned randomly to three groups. In group 1, 50 mg metoprolol, in group 2 5 mg nebivolol, and in group 3 90 mg diltiazem therapy was initiated five days before surgery. Samples of internal mammary artery were obtained intraoperatively. Nitric oxide synthase activity was measured by the quantitative sandwich enzyme-linked immunosorbent assay and graft free flow was calculated.

Results: The mean tissue nitric oxide synthase activity was found to be 0.4±0.0 U/mg in group 1, 2.4±0.3 U/mg in group 2 and 0.4±0.0 U/mg in group 3. There was a significant difference in the mean tissue nitric oxide synthase activity among the groups (p<0.05) with a higher rate in group 2. The mean graft free flow was significantly higher in group 2 compared to other groups (p<0.01).

Conclusion: Our study results suggest that preoperative nebivolol therapy increases tissue nitric oxide synthase concentration and graft free flow in the human internal mammary artery compared to metoprolol and diltiazem.

Keywords : Coronary artery bypass grafting; internal mammary artery; nebivolol; nitric oxide; nitric oxide synthase
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