Sodium nitroprusside in patients with compromised left ventricular function undergoing coronary bypass: Reduction of cardiac proinflammatory substances

Objective: The aim of the present study was to investigate whether the nitr ic oxide donor sodium nitroprusside can reduce the cardiac inflammatory res ponse during coronary artery bypass grafting in patients with severely comp romised left ventricular function, Methods: Patients (n = 30) were assigned to receive placebo or sodium nitroprusside (0.5 mu g . kg(-1) . min(-1)) f or the first 60 minutes of reperfusion, Interleukin 6, interleukin 8, and t umor necrosis factor alpha: levels; platelet adhesion molecule CD41 and CD6 2 levels; and CD11b on leukocytes were determined in the radial artery and coronary sinus before cardiopulmonary bypass and during repel fusion (1, 5, 10, 35, and 75 minutes), Results: At 1 minute of reperfusion, coronary ven ous levels of CD41-positive polymorphonuclear leukocytes were 8% lower than arterial levels in the placebo group and 18% higher in the sodium nitropru sside group (P =.021), At 5 minutes of reperfusion, the respective levels w ere 29% and 1% for interleukin 6 (P =.015), -5% and 20% for CD41-positive m onocytes (P =.032), and -2% and 16% for CD11b-positive monocytes (P =.038), At 10 minutes of reperfusion, these levels were -14% and 21% for CD41-posi tive monocytes (P =.006). At 35 minutes of reperfusion, these levels were - 13% and 7% for CD41-positive monocytes (P =.017), -41% and 23% for CD11b-po sitive monocytes (P =.001), and 7% and 25% for CD62-positive platelets (P = .041). At 75 minutes of reperfusion, the levels were 15% and -7% for tumor necrosis factor alpha (P =.025) and -10% and 10% for CD62-positive platelet s (P = .041), Conclusions: Transcardiac production of proinflammatory cytok ines is reduced in patients undergoing coronary artery bypass grafting trea ted with the nitric oxide donor sodium nitroprusside. At the same time, les s activated leukocytes and platelets are retained in the coronary circulati on.