Hyperglycemia Prevents Isoflurane-induced Preconditioning against Myocardial Infarction

Abstract

Acute hyperglycemia attenuates reductions in myocardial infarct size produced by isoflurane in dogs.

Sevoflurane Postconditioning Protects Chronically-Infarcted Rat Hearts against Ischemia-Reperfusion Injury by Activation of Pro-survival Kinases and Inhibition of Mitochondrial Permeability Transition Pore Opening upon Reperfusion

“…Hyperglycemia and hypercholesterolemia were reported to inhibit ischemic preconditioning, too. [24][25][26] Trabecula from heart failure patients also has impaired response to ischemic preconditioning. 7) However, in accordance with our findings in the current study, evidence from clinical studies shows that sevoflurane has superior cardioprotective effects than propofol in elderly patients undertaking coronary artery bypass surgery.…”

The effects of interrupted or continuous administration of sevoflurane on preconditioning before cardio‐pulmonary bypass in coronary artery surgery: comparison with continuous propofol

“…However, laboratory experiments are often performed in young, healthy animals free of the chronic medications taken by patients undergoing major cardiac surgery [25]. Diabetes, cardiac hypertrophy, increased age and even the commonly used b-blockers [26][27][28] may all obtund any preconditioning stimulus exerted by anaesthetic. Therefore, the results of laboratory investigations cannot be transferred to the clinical setting without restrictions.…”

“…, pages 1046-1055 . ..................................................................................................................................................................................................................... Ó 2008 The Authors dose (higher concentrations affording greater protection), the number of exposures to anaesthetic (more exposures being more protective), and the duration of the subsequent ischaemic injury (with shorter durations associated with better protection) [27,29,30]. In clinical practice, however, these interventions are constrained.…”

Differences in myocardial PTEN expression and Akt signalling in type 2 diabetic and nondiabetic patients undergoing coronary bypass surgery

“…Unfortunately, the diabetic myocardium is resistant to physical or pharmacologic preconditioning stimulus 5 . Experimental studies have detected corrupted protective signal transduction pathways and enhanced mitochondrial permeability transition, which could explain the increased susceptibility to injury in ischemia-reperfused diabetic myocardium 4,6 . However, the in vivo characteristics that could place patients at risk during surgery have yet to be fully delineated.…”