Myocardial oxidative stress protection by sevoflurane vs. propofol

Ballester, Mayte; Llorens, J.; García-de-la-Asunción, José; Pérez-Griera, Jaime; Tebar, Eduardo; Martínez-León, Juan; Juez, Marina

doi:10.1097/eja.0b013e32834bea2a

Cited by 33 publications

(13 citation statements)

References 31 publications

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“…Finally, it has been suggested that certain anesthesia agents can exert antioxidant activity. Ballester et al recently reported a study comparing the effect of the anaesthetics sevoflurane and propofol on F 2 -IsoP levels in blood samples taken from the coronary sinus of 38 patients undergoing elective off-pump CABG surgery [136]. Interestingly, F 2 -IsoPs did not increase in the patients on sevoflurane while signifi-cant increases were noted in the group who received propofol.…”

Section: Isoprostanes As Biomarkers Of Oxidative Stress In Human Dmentioning

confidence: 99%

The isoprostanes—25 years later

Milne

Dai

Roberts

2015

Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biolog

281

237

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Isoprostanes (IsoPs) are prostaglandin-like molecules generated independent of the cyclooxygenase (COX) by the free radical-induced peroxidation of arachidonic acid. The first isoprostane species discovered were isomeric to prostaglandin F2α and were thus termed F2-IsoPs. Since the initial discovery of the F2-IsoPs, IsoPs with differing ring structures have been identified as well as IsoPs from different polyunsaturated fatty acids, including eicosapentaenoic acid and docosahexanenoic acid. The discovery of these molecules in vivo in humans has been a major contribution to the field of lipid oxidation and free radical research over the course of the past 25 years. These molecules have been determined to be both biomarkers and mediators of oxidative stress in numerous disease settings. This review focuses on recent developments in the field with an emphasis on clinical research. Special focus is given to the use of IsoPs as biomarkers in obesity, ischemia-reperfusion injury, the central nervous system, cancer, and genetic disorders. Additionally, attention is paid to diet and lifestyle factors that can affect endogenous levels of IsoPs. This article is part of a Special Issue entitled “Oxygenated metabolism of PUFA: analysis and biological relevance”.

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Section: Isoprostanes As Biomarkers Of Oxidative Stress In Human Dmentioning

confidence: 99%

The isoprostanes—25 years later

Milne

Dai

Roberts

2015

Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biolog

281

237

View full text Add to dashboard Cite

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“…In contrast to Wang et al., who demonstrated a cardioprotective effect of sevoflurane during CABG without CPB [ 103 ], five other study groups did not observe a similar effect [ 107 , 108 , 113 , 114 , 117 ]. Three of these trials recruited small numbers of patients with n = 18, [ 107 ], n = 20 [ 108 ] and n = 38 [ 114 ], which may have contributed to the negative results, as they are likely to have been statistically underpowered. In addition, the relatively short duration of ischaemia during CABG without CPB, and the low doses of sevoflurane used, may have contributed to the confounding results.…”

Section: Clinical Evidence Of Anaesthetic Preconditioningmentioning

confidence: 58%

Peri‐operative anaesthetic myocardial preconditioning and protection – cellular mechanisms and clinical relevance in cardiac anaesthesia

2015

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Preconditioning has been shown to reduce myocardial damage caused by ischaemia–reperfusion injury peri-operatively. Volatile anaesthetic agents have the potential to provide myocardial protection by anaesthetic preconditioning and, in addition, they also mediate renal and cerebral protection. A number of proof-of-concept trials have confirmed that the experimental evidence can be translated into clinical practice with regard to postoperative markers of myocardial injury; however, this effect has not been ubiquitous. The clinical trials published to date have also been too small to investigate clinical outcome and mortality. Data from recent meta-analyses in cardiac anaesthesia are also not conclusive regarding intra-operative volatile anaesthesia. These inconclusive clinical results have led to great variability currently in the type of anaesthetic agent used during cardiac surgery. This review summarises experimentally proposed mechanisms of anaesthetic preconditioning, and assesses randomised controlled clinical trials in cardiac anaesthesia that have been aimed at translating experimental results into the clinical setting.

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“…If the anoxic condition is maintained for long, cellular dysfunction occurs as a result of decreased adenosine 5′ phosphate supply and the resultant changes in the internal environment homeostasis lead to structural damage to cardiomyocytes. The damage to cardiomyocytes has been attributed to several pathophysiological processes, including oxidative stress (15), overactivated inflammatory responses (16,17) and calcium overload (18) in the plasma of the cardiomyocytes. Therefore, interventional strategies targeting these processes may help identify cardioprotective agents that may be useful for administration during the procedures of CPB and open-heart cardiac surgery.…”

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

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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.

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Myocardial oxidative stress protection by sevoflurane vs. propofol

Abstract: In patients undergoing off-pump CABG, sevoflurane showed better antioxidative properties than propofol.

Cited by 33 publications

References 31 publications

The isoprostanes—25 years later

The isoprostanes—25 years later

Peri‐operative anaesthetic myocardial preconditioning and protection – cellular mechanisms and clinical relevance in cardiac anaesthesia

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

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