Mechanisms of Cardioprotection by Volatile Anesthetics

Tanaka, Katsuya; Ludwig, Lynda M.; Kersten, Judy R.; Pagel, Paul S.; Warltier, David C.

doi:10.1097/00000542-200403000-00035

Cited by 249 publications

(151 citation statements)

References 152 publications

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“…1,2 The underlying cellular and molecular mechanisms involved are not thoroughly understood, but the overall mechanism, which has been the focus of intense investigation, is likely multifactorial.…”

Section: Résumémentioning

confidence: 99%

The protective effects of emulsified isoflurane on myocardial ischemia and reperfusion injury in rats

Luo

Liu

2008

Can J Anesth/J Can Anesth

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Purpose Pretreatment with volatile anesthetics has been demonstrated to exert cardioprotective effects. The purpose of this study was to examine the effect of emulsified isoflurane, a new formulation of isoflurane in lipid emulsion, administered intravenously in an ischemia and reperfusion model of myocardial injury. Methods Thirty-two Sprague Dawley rats of both sexes were subjected to 30 min of myocardial ischemia followed by 180 min of reperfusion. Each was assigned to one of four pretreatment groups to receive an isovolumetric intravenous infusion of saline: control group, 30% intralipid group, 8% emulsified isoflurane 2 ml kg -1 group, and sham group (each group, n = 8). The vehicles were administered at a constant rate for 30 min and then discontinued 30 min before left anterior descending coronary artery occlusion. The cardioprotective effects were examined by determining hemodynamics, infarct size, enzyme activity, and cardiomyocytic apoptosis. Results Pretreatment with emulsified isoflurane 2 ml kg -1 (P = 0.000) significantly reduced infarct size (22.6 ± 2.2%) compared with control (34.8 ± 2.3%) and 30% intralipid (31.1 ± 2.9%). When compared with the control and intralipid groups, emulsified isoflurane increased Bcl-2 expression while decreasing Bax and Caspase-3 expression and enhancing Bcl-2/Bax ratios. The apoptotic index in the emulsified isoflurane treatment group showed a significant reduction compared with that in the control group (P = 0.000) and the intralipid group (P = 0.001). In addition, the serum levels of lactate dehydrogenase and creatine kinase were markedly reduced in the emulsified isoflurane treatment group compared with the control and intralipid groups (lactate dehydrogenase, P = 0.015 vs. control; creatine kinase, P = 0.000 vs. control and intralipid). Conclusion These data support a cardioprotective effect of intravenous emulsified isoflurane against myocardial ischemia and reperfusion injury, which are mediated, at least in part, by the inhibition of apoptosis and cell damage. RésuméObjectif Il a e´te´de´montre´que les agents anesthe´siques volatils exercent un effet cardioprotecteur lorsqu'ils sont administre´s en traitement pre´ventif. L'objectif de cette e´tude e´tait d'examiner l'effet d'une e´mulsion d'isoflurane, une nouvelle formulation d'isoflurane en e´mulsion lipidique, administre´e par voie intraveineuse dans un mode`le d'ische´mie reperfusion de le´sion myocardique. Méthode Trente-deux rats Sprague Dawley des deux sexes ont e´te´soumis a`30 min d'ische´mie myocardique suivie de 180 min de reperfusion. Chaque rat a e´te´rand-omise´dans l'un des quatre groupes de pre´traitement suivants, recevant tous une perfusion intraveineuse isovolume´trique de solution saline : groupe te´moin, groupe intralipide 30%, groupe e´mulsion d'isoflurane 8% 2 mL kg -1 , et groupe sans intervention (pour chaque groupe, n = 8). Les ve´hicules ont e´te´administre´s à un taux constant durant 30 min puis interrompu 30 min avant l'occlusion de l'arte`re coronaire descendante ante´rieure

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Section: Résumémentioning

confidence: 99%

The protective effects of emulsified isoflurane on myocardial ischemia and reperfusion injury in rats

Luo

Liu

2008

Can J Anesth/J Can Anesth

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“…This anesthetic-induced pharmacological preconditioning has been the subject of considerable research and has been shown to protect the heart against myocardial infarction in a variety of experimental animal models as well as in humans. 2 In the current issue of the Journal, Hu et al 3 report on the protective effects of emulsified isoflurane against myocardial ischemia, using an in vivo model of regional myocardial ischemia and reperfusion in rats. Intravenous administration of emulsified isoflurane, prior to ischemia and reperfusion, reduced myocardial infarct size by approximately 40% and decreased apoptotic cell death.…”

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confidence: 99%

“…Ce pré-conditionnement pharmacologique induit par l'anesthésie a fait l'objet de nombreuses recherches et il a été démontré, dans plusieurs modèles animaux expérimentaux aussi bien que chez les humains, qu'il protégeait le coeur contre l'infarctus du myocarde. 2 Dans ce numéro du Journal, Hu et coll. 3 font état des effets protecteurs d'une émulsion d'isoflurane contre l'ischémie myocardique à l'aide d'un modèle in vivo d'ischémie myocardique régionale et de reperfusion chez le rat.…”

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Intravenous administration of halogenated inhaled anesthetics—research tool or real application?

Raphael

Lynch

2009

Can J Anesth/J Can Anesth

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“…Finally, APC involves ion channels, in particular the mitochondrial and the sarcolemmal K ATP channels. The mechanisms involved in APC have been a subject of several detailed review articles (3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Myocardial protection by volatile anesthetics is of clinical importance for patients with coronary artery disease because of their high morbidity and because of their mortality that is secondary to perioperative myocardial ischemia.…”

mentioning

confidence: 99%

“…Our laboratory and other studies have identified a signaling cascade that involves ROS, G-protein coupled receptors, protein kinases and ATP-sensitive potassium (K ATP ) channels. (11,12, Volatile anesthetics are very powerful agents in reducing infarct size and the ATP-sensitive potassium (K ATP ) channels have long been considered essential components of cardiac preconditioning. There are two types of K ATP channels in cardiac myocytes: the mitochondrial (mitoK ATP ) channel which is located in the inner mitochondrial membrane, and the sarcolemmal (sarcK ATP ) channel which is located in the plasma membrane.…”

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confidence: 99%

Anesthetics and cardioprotection

Bošnjak

2007

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Mechanisms of Cardioprotection by Volatile Anesthetics

Cited by 249 publications

References 152 publications

The protective effects of emulsified isoflurane on myocardial ischemia and reperfusion injury in rats

The protective effects of emulsified isoflurane on myocardial ischemia and reperfusion injury in rats

Intravenous administration of halogenated inhaled anesthetics—research tool or real application?

Anesthetics and cardioprotection

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