Cardioprotective Effects Induced by Preconditioning with Halogenated Anesthetics

Abstract

backgroundIn the organ transplantation field, a very intense and important topic is to find ways to increase the quality of organs that are taken from willing donors, in order to improve the recovery capacity of the transplant recipients. 1 From the moment of the organ removal until its actual transplantation, there is a variable period of ischemia, named cold-ischemia, responsible for the production Cardioprotective Effects Induced by Preconditioning with Halogenated AnestheticsMarius Papurica 1,2 , Dorel Sandesc 1,2 , Alexandru Florin Rogobete 1,2 , Radu Nartita 3 , Corina Vernic 2 , Sonia Elena Popovici 2 , Ovidiu Horea Bedreag 1,2 1 Clinic of Anesthesia and Intensive Care, "Pius Brinzeu" Emergency County Hospital, Timișoara, Romania 2 Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, Timișoara, Romania 3 Faculty of Chemistry, Biology, Geography, West University of Timișoara, Romania ABSTRACT Background: Numerous studies discuss the protective effects of halogenated anesthetics on myocyte injury induced by the ischemia-reperfusion syndrome of the heart. This mechanism is known as pharmacological preconditioning. Aim of the study: The objective of this study was to identify the effects of two volatile anesthetics frequently used in current clinical practice, Isoflurane and Sevoflurane, on the in situ heart. The study was performed on laboratory animals with induced brain death. Material and methods: The animals were divided into 3 groups, the control group (n = 8), IZO-PRE group (n = 8) and SEVO-PRE group (n = 8), on which the experimental protocol established for this study was applied. From a molecular point of view, the expressions of protein kinase C-epsilon (PKCε) and of glycogen synthase kinase -3 beta (GSK-3β) were investigated. Results: Following the statistical analysis, we observed a significant reduction in the size of the infarcted area in the IZO-PRE group compared to the control group (p <0.0001). Regarding the SEVO-PRE group, no reduction was observed (p >0.05). The expression of GSK-3β is more pronounced in case of the SEVO-PRE group, at 5 minutes after reperfusion, and the effect disappears after 15 minutes. The expression of PKCε as a total form of the enzyme, occurs at 5 minutes after reperfusion in the SEVO-PRE group and late in the IZO-PRE group (after 15 minutes). Conclusions: Both anesthetics that were applied showed a cardioprotective effect. Isoflurane provided a better structural and morphological protection, but Sevoflurane resulted in a more effective protection in terms of functionality, significantly reducing the incidence of extremely severe life-threatening arrhythmias.

Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study

“…Furthermore, the increased vascular resistance leads to an increased motor load of the heart with tachycardia which can lead to hemodynamic collapse [ 16 , 17 , 18 , 19 , 20 ]. It is well-known that one of the pharmacodynamic effects of volatile anesthetics is their impact on the heart function [ 21 , 22 , 23 ], but it should be noted that, apart from its effects on the hemodynamic status, Sevoflurane also has cardioprotective properties. From a molecular point of view, the cardioprotective effects are attained through its action on adenosine triphosphate-sensitive channels which can be found in the cardiac myocytes.…”

Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

“…[16][17][18][19][20]. It is a known fact that one of the pharmacodynamic effects of volatile anesthetics is their impact on the heart function [21][22][23], but it should be noted that apart from its effects on the hemodynamic status, Sevoflurane also has cardioprotective properties. From a molecular point of view the cardioprotective effects are attained through its action on adenosine triphosphate sensitive channels that can be found in the cardiac myocites.…”

The Impact of General Anesthesia on Redox Stability and Epigenetic Inflammation Pathways: Crosstalk on Perioperative Antioxidant Therapy

“…Several studies have demonstrated that these two agents can reduce the levels of reactive species of oxygen, inhibit chemotaxis, and inhibit the activation of neutrophils, leading to decreased neutrophil adhesion to human endothelial cells, decreased IL-6 and TNF-α, suppressed PMN migration and function through various pathways, altered cytokine release from macrophages, and decreased NK cytotoxic activity. A study comparing two anesthetic techniques, TIVA and balanced inhalational anesthesia, found that perioperative cell-mediated immunity was less influenced by TIVA, suggesting that the stress response in patients undergoing anesthesia with a volatile agent is more pronounced [ 102 , 103 , 104 , 105 , 106 , 107 ].…”