Les effets des anesthésiques volatils sur les complications ischémiques et la mortalité cardiaques pendant le PAC: une méta-analyse

Yu, Chun Hua; Beattie, W. Scott

doi:10.1007/bf03022834

Cited by 144 publications

(79 citation statements)

References 45 publications

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“…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 . However, little is known on how APC influences the autonomic modulation of the heart after the acute phase of a myocardial ischemia-reperfusion.…”

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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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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“…17 Several meta-analyses showed that volatile anesthetics were associated with a reduction in postoperative troponin release, although not all showed an effect on clinical outcome. 15,18 It is possible that volatile anesthetics have a different cardioprotective effect in patients not undergoing heart surgery. 19 Therefore, to explore a potential cardioprotective effect of sevoflurane during pPCI, we performed the Sevoflurane In Acute Myocardial Infarction (SIAMI) trial.…”

Section: Résumémentioning

confidence: 99%

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Lavi

Alemayehu

McCarty

et al. 2015

Can J Anesth/J Can Anesth

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Background Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction. Methods In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control). From the time of the patient's arrival for cardiac catheterization, the anesthesia team administered sevoflurane or oxygen for 30 min using a tight-fitting mask.In this substudy, we report the one-year outcomes. Patients were followed clinically for one year; they underwent a thallium cardiac viability study at six months and an echocardiogram at one year. Results Forty-six patients completed follow-up. One patient in the sevoflurane group died. The mean [standard deviation (SD)] ejection fraction by singlephoton emission computed tomography at six months was 51.7 (7.7)% in the sevoflurane group and 51 (9.1)% in the control group (mean difference, 0.7%; 95% confidence interval [CI], -5.9 to 7.3; P = 0.831). The median [interquartile range] amount of scarring at six months was 0% [0 -8] in the sevoflurane group and 2.5% [0 -7.1] in control group (mean difference, -0.1%; 95% CI, -4.6 to 4.4; P = 0.700). The mean (SD) percentage of hibernating myocardium was similar in both groups 0% [0, 5] (mean difference, -1.3%; 95% CI, -3.4 to 0.9; P = 0.259). The mean (SD) ejection fraction at one year increased compared with baseline by 8.0 (9.1)% (P \ 0.001).Conclusions In this study, we did not find an effect of sevoflurane on left ventricular function or myocardial injury at one year post STEMI. This trial was registered at www.clinicaltrials.gov; identifier: NCT00971607. RésuméContexte Le sévoflurane est un anesthésique inhalé qui a des effets cardioprotecteurs. On ne dispose que de peu Meeting presentation: Presented in part at the Canadian Cardiovascular Congress in Vancouver, 2014 and published as an abstract (Can J Cardiol 2014, 30 (10): s62.).

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“…[3][4][5] In the current issue of the Journal, Ansley et al have pursued a different approach: They report the results of their clinical Phase 2 trial (PRO-TECT II) that assessed the impact of administering a targeted dose of systemic propofol during the ischemia-reperfusion interval in patients undergoing heart surgery. 6 They hypothesized that the antioxidant properties of propofol impart anesthetic preconditioning and protect ischemic myocardium from oxidative injury during cardiac surgery.…”

mentioning

confidence: 99%

“…In juxtaposition to Ansley et al, several meta-analyses have demonstrated trends toward more favorable outcomes with inhalation anesthetics. [3][4][5] Yu and Beattie assessed a heterogeneous group of studies that demonstrated a trend toward decreased mortality with inhalation anesthetics. 3 Sevoflurane and desflurane, but not isoflurane, were associated with a decrease in postoperative troponin levels.…”

mentioning

confidence: 99%

“…[3][4][5] Yu and Beattie assessed a heterogeneous group of studies that demonstrated a trend toward decreased mortality with inhalation anesthetics. 3 Sevoflurane and desflurane, but not isoflurane, were associated with a decrease in postoperative troponin levels. Similarly, an analysis of volatile anesthetics by Symons and Myles found that they produced higher cardiac output indices and lowered serum troponin levels.…”

mentioning

confidence: 99%

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L’étude de la cardioprotection induite par le propofol: du mécanisme au phénomène clinique, et vice-versa

Hare

2015

Can J Anesth/J Can Anesth

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Les effets des anesthésiques volatils sur les complications ischémiques et la mortalité cardiaques pendant le PAC: une méta-analyse

Cited by 144 publications

References 45 publications

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

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

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

L’étude de la cardioprotection induite par le propofol: du mécanisme au phénomène clinique, et vice-versa

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