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Angiotensin-converting enzyme (ACE) inhibitors have cardioprotective effects in animals, but whether that occurs in humans is still controversial. The effect of myocardial ACE activity on coronary vascular resistance during coronary artery bypass surgery and on serum brain natriuretic peptide (BNP) concentration after surgery was studied in myocardial tissue sampled from the right atrium of patients during cardiac surgery (n=20). Tissue enzyme activity (nmol/min per mg protein) was measured using a photometric technique, and the flow rate and pressure upon antegrade infusion of a crystalloid cardioplegic solution was measured for calculating the coronary vascular resistance (mmHg. ml(-1). min(-1)). Serum BNP concentration (pg/ml) was measured on days 0 and 5 after the surgery. Linear regression between tissue ACE activity and coronary vascular resistance (y = 0.46x + 0.56, r=0.85) as well as serum BNP concentration on days 0 (y = 129x + 30, r=0.59) and 5 (y = 347x + 180, r=0.73) after the surgery was significant (x: ACE activity; y: coronary vascular resistance/serum BNP concentration). The results indicate that inhibition of myocardial ACE activity might improve coronary circulation during surgery and hence, cardiac function after surgery.

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complicate hypertension. Our findings suggest that age at repair might not be as important in the development of left ventricular hypertrophy and vascular damage in postcoarctectomy patients as is often believed.Our findings support the hypothesis that aortic coarctation forms part of an extensive developmental abnormality of the proximal systemic arterial system also involving the left ventricle and the carotid arteries. Nowadays, early correction is recommended to reduce the risk of future sustained hypertension, but its effect on the left ventricle and proximal arteries might be less important than previously thought. References 1. Johnson MC, Gutierrez FR, Sekarski DR, Ong CM, Canter CE. Comparison of ventricular mass and function in early versus late repair of coarctation of the aorta.

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