Esmolol Protects the Myocardium and Facilitates Direct Version Intracardiac Operation With a Beating Heart

Deng, Yun-kun; Fang, Wei; Li, Zheng-Lun; Daguo, Zhang; Yang, Shiyu

doi:10.1253/circj.66.715

Cited by 7 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been used in a number of clinical situations in which rapid reversal of effect may be necessary, including during acute myocardial ischemia and during cardiopulmonary bypass surgery. 25,26 Esmolol was chosen in this study because its period of action was similar to the duration of the catecholamine surge measured by tissue microdialysis after prolonged VF and resuscitation. We did see a blunting of the maximum systolic arterial blood pressure after ROSC, showing that esmolol did moderate the functional effects of the catecholamine surge.…”

Section: Discussionmentioning

confidence: 99%

Short-Acting β-Adrenergic Antagonist Esmolol Given at Reperfusion Improves Survival After Prolonged Ventricular Fibrillation

et al. 2004

View full text Add to dashboard Cite

Background— High catecholamine concentrations are cytotoxic to cardiac myocytes. We hypothesized that myocardial interstitial catecholamine levels are greatly elevated immediately after long-duration ventricular fibrillation (VF), defibrillation, and reperfusion and that the short-acting β-antagonist esmolol administered at reperfusion would protect against this catecholamine surge and improve survival. Methods and Results— In part 1 of this study, catecholamines from myocardial interstitial fluid (ISF) and aortic and coronary sinus plasma were quantified by use of 3 H-labeled radioenzymatic assay in 8 open-chest, anesthetized pigs. Eight minutes of electrically induced VF was followed by internal defibrillation and reperfusion. By 4 minutes of VF, ISF norepinephrine increased significantly, from 1.3±0.3 to 7.4±2.4 ng/mL. Epinephrine increased significantly, from 0.4±0.2 to 1.5±0.7 ng/mL. ISF norepinephrine and epinephrine peaked at 219.2±92.1 and 63.7±25.1 ng/mL after defibrillation and reperfusion and decreased significantly to 12.2±3.5 and 6.7±3.1 ng/mL 23 minutes after defibrillation. Transcardiac catecholamine changes were similar. In part 2, 8 minutes of VF was followed by external defibrillation in anesthetized, closed-chest pigs. Animals received 1.0 mg/kg esmolol (n=8) or saline (n=8) intravenously at the start of cardiopulmonary resuscitation (CPR). Advanced cardiac life support, including CPR and epinephrine, was delivered to both groups. Esmolol before reperfusion improved return of spontaneous circulation and 4-hour survival (7/8 versus 3/8 survivors, χ 2 P <0.05). Conclusions— Transcardiac and ISF norepinephrine and epinephrine levels are briefly massively elevated after 8 minutes of VF, defibrillation, and reperfusion. A short-acting β-antagonist administered immediately after defibrillation improves return of spontaneous circulation and 4-hour survival after this prolonged VF.

show abstract

Section: Discussionmentioning

confidence: 99%

Short-Acting β-Adrenergic Antagonist Esmolol Given at Reperfusion Improves Survival After Prolonged Ventricular Fibrillation

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Deng et al (28) reported that in a direct vision of an intracardiac beating-heart surgery, esmolol protects the myocardium and facilitates the operation, as demonstrated by the maintenance of the myocardial ultrastructure. In addition, Scorsin et al (29) measured the transmyocardial gradient of the oxygen content and revealed that esmolol provides potent myocardial protection in hypertrophied hearts, at least partly, by reducing the myocardial oxygen metabolism.…”

Section: Discussionmentioning

confidence: 99%

A pilot study of perioperative esmolol for myocardial protection during on-pump cardiac surgery

Liu

Shao

Liu

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

The protective effects of preprocedural esmolol on myocardial injury and hemodynamics have not, to date, been investigated in patients who were scheduled for cardiac surgeries under a cardiopulmonary bypass (CPB). A pilot randomized controlled trial was performed at The First Affiliated Hospital of Dalian Medical University (Dalian, China). Patients scheduled for elective open-heart surgeries under CBP were included, and were randomized to esmolol and control groups. For patients in the esmolol groups, intravenous esmolol (70 µg/kg/min) was administered at the time of incision until CPB was performed. For patients assigned to the control group, equal volumes of 0.9% saline were administered. Markers of myocardial injury and hemodynamic parameters were observed until 12 h post surgery. A total of 24 patients were included in the present study. No significant differences in hemodynamic parameters, including the central venous pressure and heart rate, were detected between patients in the two groups during the perioperative period or within the first 12 h post-surgery (P>0.05), except for the mean arterial pressure, which was higher in the esmolol group compared with the control group at 5 and 12 h post-surgery (P<0.05). However, the serum level of cardiac troponin I was higher in patients of the control group compared with those of the esmolol group during the preoperative period (P<0.05). Although creatinine kinase was significantly different at T2 between the two groups, its MB isoenzyme was not significantly different between the groups (P>0.05). In addition, administration of esmolol was not associated with an increased risk for severe complications and adverse events in these patients. In conclusion, preoperative esmolol may be an effective and safe measure of myocardial protection for patients who undergo elective cardiac surgeries under CBP.

show abstract

“…По сообщению авторов, эсмолол при внутривенном введении эффективно и обратимо снижал частоту сердечных сокращений и диастолическое артериальное давление без каких бы то ни было серьезных неблагоприятных воздействий [13]. В другом рандомизированном плацебо-контролируемом исследовании было показано, что ранняя терапия внутривенными бета-адреноблокаторами достоверно уменьшает размеры инфаркта миокарда [14].…”

Section: Lecture лекцияunclassified

Можливості Застосування Кардіоселективних Парентеральних Бета-Блокаторів У Медицині Невідкладних Станів

Nіkonov¹,

Sokolov²,

Kinoshenko³

2021

ЕМ

View full text Add to dashboard Cite

Parenteral cardioselective beta-blocker-esmolol has unique pharmacokinetic and pharmacological effects that become attractive at the stage of emergency care. The ultrashort action along with the antihypertensive effect is accompanied by the significant anti-ischemic, cardioprotective and antiarrhythmic action, which makes it an ideal beta-adrenoblocker for prehospital and early hospital stages in the treatment of acute coronary syndrome, supraventricular tachycardia of various origin, hypertensive crises. The practical advantages of esmolol are the possibility of prolonged administration and individual titration of dosages, as well as rapid (within 30 minutes) reversibility of the effect and, accordingly, drug safety.

show abstract

Esmolol Protects the Myocardium and Facilitates Direct Version Intracardiac Operation With a Beating Heart

Cited by 7 publications

References 15 publications

Short-Acting β-Adrenergic Antagonist Esmolol Given at Reperfusion Improves Survival After Prolonged Ventricular Fibrillation

Short-Acting β-Adrenergic Antagonist Esmolol Given at Reperfusion Improves Survival After Prolonged Ventricular Fibrillation

A pilot study of perioperative esmolol for myocardial protection during on-pump cardiac surgery

Можливості Застосування Кардіоселективних Парентеральних Бета-Блокаторів У Медицині Невідкладних Станів

Contact Info

Product

Resources

About