Enflurane Enhances Postischemic Functional Recovery in the Isolated Rat Heart

Freedman, Bruce M.; Hamm, David P.; Everson, Charles T.; Wechsler, Andrew S.; Christian, Charles M.

doi:10.1097/00000542-198501000-00006

Cited by 56 publications

(23 citation statements)

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“…Enflurane was observed to reduce lactate production in myocardium distal to a coronary artery stenosis (42). In isolated hearts, halothane (9), enflurane (20), isoflurane (29), and sevoflurane (29) have been shown to improve function following global ischemia. Halothane and isoflu- Fig.…”

Section: Discussionmentioning

confidence: 99%

Delayed cardioprotection by isoflurane: role of K_ATP channels

Tonkovic-Capin¹,

Gross²,

Bošnjak³

et al. 2002

American Journal of Physiology-Heart and Circulatory Physiology

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Isoflurane mimics the cardioprotective effect of acute ischemic preconditioning with an acute memory phase. We determined whether isoflurane can induce delayed cardioprotection, the involvement of ATP-sensitive potassium (KATP) channels, and cellular location of the channels. Neonatal New Zealand White rabbits at 7-10 days of age (n ϭ 5-16/group) were exposed to 1% isoflurane-100% oxygen for 2 h. Hearts exposed 2 h to 100% oxygen served as untreated controls. Twenty-four hours later resistance to myocardial ischemia was determined using an isolated perfused heart model. Isoflurane significantly reduced infarct size/area at risk (means Ϯ SD) by 50% (10 Ϯ 5%) versus untreated controls (20 Ϯ 6%). Isoflurane increased recovery of preischemic left ventricular developed pressure by 28% (69 Ϯ 4%) versus untreated controls (54 Ϯ 6%). The mitochondrial KATP channel blocker 5-hydroxydecanoate (5-HD) completely (55 Ϯ 3%) and the sarcolemmal KATP channel blocker HMR 1098 partially (62 Ϯ 3%) attenuated the cardioprotective effects of isoflurane. The combination of 5-HD and HMR-1098 completely abolished the cardioprotective effect of isoflurane (56 Ϯ 5%). We conclude that both mitochondrial and sarcolemmal KATP channels contribute to isoflurane-induced delayed cardioprotection. ischemia; heart; infarct size; volatile anesthetics; myocardial preconditioning BRIEF PERIODS OF ISCHEMIA lead to a reduced severity of cardiac injury following a second sustained period of ischemia. This cardioprotective effect has been termed ischemic preconditioning and has been demonstrated in all species studied. Certain pharmacological agents can mimic the cardioprotective effect of ischemic preconditioning. Recent clinical and experimental data indicate that volatile anesthetics also exert acute protective effects on the myocardium.The protective effects of volatile anesthetics on ischemic myocardium have been termed anesthetic-induced preconditioning because of its remarkable similarity to ischemic preconditioning. Isoflurane improves functional recovery of stunned myocardium in chronically or acutely instrumented dogs after brief periods of coronary artery occlusion and reperfusion (25,26,44). Low doses of the ATP-sensitive K (K ATP ) channel blocker glibenclamide completely abolished the cardioprotective effects of isoflurane (25). These results indicate that K ATP channels are activated by isoflurane and mediate the beneficial effects of isoflurane in stunned myocardium in animal models that respond to acute ischemic preconditioning in a similar fashion to the human heart (5, 45).K ATP channel openers mimic early ischemic preconditioning, whereas K ATP channel blockers prevent ischemic preconditioning. These effects were initially attributed to opening and closing of sarcolemmal K ATP channels, respectively. New evidence suggests, however, that mitochondrial K ATP channels might very well have even a greater influence on preconditioning (35, 37). For instance, diazoxide, an opener of mitochondrial K ATP channels, was demonstrated to exert ca...

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Section: Discussionmentioning

confidence: 99%

Delayed cardioprotection by isoflurane: role of K_ATP channels

Tonkovic-Capin¹,

Gross²,

Bošnjak³

et al. 2002

American Journal of Physiology-Heart and Circulatory Physiology

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“…General inhaled anesthesics, with the exception of nitrous oxide, have been studied for their cardioprotective effects since the demonstration that enflurane prevents post-ischemic ventricular dysfunction after global myocardial ischemia in isolated rat hearts 1 . The effects of Anesthetics as cardioprotective agents are well-known and anaesthesic preconditioning (APC) is capable of a reduction of infarct size and mortality after myocardial infarction 2,3 , troponin I release after coronary artery bypass graft surgery 4 and prevention of acute kidney injury 5 .…”

Section: Introductionmentioning

confidence: 99%

Sevoflurane preconditioning during myocardial ischemia-reperfusion reduces infarct size and preserves autonomic control of circulation in rats

Pasqualin

Mostarda²,

Souza³

et al. 2016

Acta Cir. Bras.

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PURPOSE:To investigate the myocardial ischemia-reperfusion with sevoflurane anesthetic preconditioning (APC) would present beneficial effects on autonomic and cardiac function indexes after the acute phase of a myocardial ischemia-reperfusion. METHODS:Twenty Wistar rats were allocated in three groups: control (CON, n=10), myocardial infarction with sevoflurane (SEV, n=5) and infarcted without sevoflurane (INF, n=5). Myocardial ischemia (60 min) and reperfusion were performed by temporary coronary occlusion. Twenty-one days later, the systolic and diastolic function were evaluated by echocardiography; spectral analysis of the systolic arterial pressure (SAPV) and heart rate variability (HRV) were assessed. After the recording period, the infarct size (IS) was evaluated. RESULTS:The INF group presented greater cardiac dysfunction and increased sympathetic modulation of the SAPV, as well as decreased alpha index and worse vagal modulation of the HRV. The SEV group exhibited attenuation of the systolic and diastolic dysfunction and preserved vagal modulation (square root of the mean squared differences of successive R-R intervals and high frequency) of HRV, as well as a smaller IS. CONCLUSION:Sevoflurane preconditioning better preserved the cardiac function and autonomic modulation of the heart in postacute myocardial infarction period.Key words: Autonomic Nervous System. Heart Rate. Myocardial Infarction. Ischemic Preconditioning, Myocardial. Rats. Sevoflurane preconditioning during myocardial ischemia-reperfusion reduces infarct size and preserves autonomic control of circulation in rats

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“…It is well established in the experimental literature that inhaled anesthetic agents (such as isoflurane, sevoflurane, desflurane and enflurane) confer powerful cardioprotection in animal models of acute IRI [7,11,21]. A number of meta-analyses have suggested beneficial effects with inhaled anesthetic agents when compared to intravenous anesthetic agents in patients undergoing cardiopulmonary bypass surgery, in terms of less PMI and possibly improved clinical outcomes [24,34,43].…”

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confidence: 99%

“Conditional Conditioning” in cardiac bypass surgery

Hausenloy

Yellon

2012

Basic Res Cardiol

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Coronary artery bypass graft (CABG) surgery remains the procedure of choice for coronary artery revascularization in patients with multi-vessel coronary artery disease (CAD). For patients undergoing elective isolated CABG surgery, clinical outcomes are very good (1.5 % in-hospital mortality in the UK) [35]. However, increasing numbers of higher risk patients are being operated, resulting in higher in-hospital mortality rates. The reasons for this increase in high risk patients include: patients being older (25 % of all cardiac surgery in the UK is in patients over 75 years of age); the increasing prevalence of co-morbidities such as diabetes (33 % increase since 2001 and in-hospital mortality of 1.9 %), left ventricular impairment (in-hospital mortality is 6.8 % in patients with poor left ventricular systolic function), extra-cardiac arteriopathy (in-hospital mortality of 2.9 %), renal impairment (in-hospital mortality of 8.9 %), previous myocardial infarction (doubles in-hospital mortality) and valvular disease (in-hospital mortality is 3.5 % for valve only surgery and 6

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Enflurane Enhances Postischemic Functional Recovery in the Isolated Rat Heart

Cited by 56 publications

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Delayed cardioprotection by isoflurane: role of K_ATP channels

Delayed cardioprotection by isoflurane: role of K_ATP channels

Sevoflurane preconditioning during myocardial ischemia-reperfusion reduces infarct size and preserves autonomic control of circulation in rats

“Conditional Conditioning” in cardiac bypass surgery

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Enflurane Enhances Postischemic Functional Recovery in the Isolated Rat Heart

Cited by 56 publications

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Delayed cardioprotection by isoflurane: role of KATP channels

Delayed cardioprotection by isoflurane: role of KATP channels

Sevoflurane preconditioning during myocardial ischemia-reperfusion reduces infarct size and preserves autonomic control of circulation in rats

“Conditional Conditioning” in cardiac bypass surgery

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Delayed cardioprotection by isoflurane: role of K_ATP channels

Delayed cardioprotection by isoflurane: role of K_ATP channels