Sevoflurane anesthesia during acute right ventricular ischemia in pigs preserves cardiac function better than propofol anesthesia

Haraldsen, Pernille; Metzsch, Carsten; Lindstedt, Sandra; Algotsson, Lars; Ingemansson, Richard

doi:10.1177/0267659116637134

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…The administration of inhaled sevoflurane increased cardiac functions with increased LVEF and LVFS and improved hemodynamic alterations with reduced LVEDP and increased the + dp/dt max and − dp/dt max. Haraldsen et al, proved that inhalation anesthesia with sevoflurane was superior to intravenous anesthesia with propofol in acute right ventricular ischemic dysfunction by preserving cardiac function. Compared with halothane, sevoflurane better restores cardiac rhythm and left ventricular function of infants and leads to favorable hemodynamic profile .…”

Section: Discussionmentioning

confidence: 99%

Downregulation of microRNA‐155 stimulates sevoflurane‐mediated cardioprotection against myocardial ischemia/reperfusion injury by binding to SIRT1 in mice

Huang

Hao²,

2019

J of Cellular Biochemistry

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Objective The inhaled sevoflurane has been demonstrated to protect against myocardial ischemia/reperfusion (I/R) injury. However, the relative mechanisms of sevoflurane‐mediated cardioprotection remain largely unknown. This study intends to explore the effect of miR‐155 on the sevoflurane‐mediated cardioprotection by regulating Sirtuin 1 (SIRT1) in mouse models of myocardial I/R. Methods Left anterior descending coronary artery ligation was used to induce models of myocardial I/R in mice. The I/R mice were treated with sevoflurane, sevoflurane + mimics negative control (NC) or sevoflurane + miR‐155 mimics. The expression of microRNA‐155 (miR‐155) and SIRT1 was examined by quantitative real‐time polymerase chain reaction and Western blot assay. Then cardiac functions and hemodynamic alterations were evaluated. Evans blue‐2,3,5‐triphenyltetrazolium chloride and terminal deoxynucleotidyl transferase‐mediated dUTP nick‐end labeling assay staining methods were adopted to evaluate infarct size and cardiomyocyte apoptosis, respectively. Results In the I/R mice, miR‐155 was expressed at a high level and SIRT1 at a low level. SIRT1 was confirmed to be a target gene of miR‐155. The treatment of sevoflurane could reduce miR‐155 expression and increased SIRT1 expression in the myocardial tissues, under which conditions, cardiac functions were promoted, accompanied by reduced infarct size and inhibited cardiomyocyte apoptosis. In response to miR‐155 upregulation, the sevoflurane‐treated I/R mice showed reduced cardiac functions, and increased infarct size and cardiomyocyte apoptosis. Conclusion The findings obtained in this study provide evidence suggesting that miR‐155 targets and negatively regulates SIRT1 expression, a mechanism by which the protection of sevoflurane is inhibited against myocardial I/R in mice.

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Section: Discussionmentioning

confidence: 99%

Downregulation of microRNA‐155 stimulates sevoflurane‐mediated cardioprotection against myocardial ischemia/reperfusion injury by binding to SIRT1 in mice

Huang

Hao²,

2019

J of Cellular Biochemistry

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“…There are controversial data in the literature regarding the effects of sevoflurane on right ventricular function. While the administration of 1–1.5 MAC of sevoflurane led to a significant decrease in right ventricular stroke work index (RVSWI) in anaesthetized pigs [31], pulmonary vascular resistance increased but RVSWI remained stable in another porcine study using a MAC of less than 1 [32]. Malan et al studied the effects of sevoflurane on healthy volunteers and showed that systemic vascular resistance and mean pulmonary artery pressures are reduced [33].…”

Section: Discussionmentioning

confidence: 99%

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: an echocardiography-based prospective observational study

et al. 2019

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BackgroundGeneral anesthesia induction with the initiation of positive pressure ventilation creates a vulnerable phase for patients. The impact of positive intrathoracic pressure on cardiac performance has been studied but remains controversial. 3D echocardiography is a valid and MRI-validated bed-side tool to evaluate the right ventricle (RV). The aim of this study was to assess the impact of anesthesia induction (using midazolam, sufentanil and rocuronium, followed by sevoflurane) with positive pressure ventilation (PEEP 5, tidal volume 6–8 ml/kg) on 2D and 3D echocardiography derived parameters of RV function.MethodsA prospective observational study on fifty-three patients undergoing elective cardiac surgery in a tertiary care university hospital was designed. Transthoracic echocardiography exams were performed before and immediately after anesthesia induction and were recorded together with hemodynamic parameters and ventilator settings.ResultsAfter anesthesia induction TAPSE (mean difference − 1.6 mm (95% CI − 2.6 mm to − 0.7 mm; p = 0.0013) as well as the Tissue Doppler derived tricuspid annulus peak velocity (TDITVs’) were significantly reduced (mean difference − 1.9% (95% CI: − 2.6 to − 1.2; p < 0.0001), but global right ventricular ejection fraction (RVEF; p = 0.1607) and right ventricular stroke volume (RVSV; p = 0.1838) did not change.ConclusionsThis data shows a preserved right ventricular ejection fraction and right ventricular stroke volume after anesthesia induction and initiation of positive pressure ventilation. However, the baso-apical right ventricular function is significantly reduced. Larger studies are needed in order to determine the clinical impact of these findings especially in patients presenting with impaired right ventricular function before anesthesia induction.Trial registrationRetrospecitvely registered, 6th June 2016, ClinicalTrials.gov Identifier NCT02820727.

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“…There are controversial data in the literature regarding the effects of sevoflurane on right ventricular function. While the administration of 1-1.5MAC of sevoflurane led to a significant decrease in right ventricular stroke work index (RVSWI) in anaesthetized pigs (31), pulmonary vascular resistance increased but RVSWI remained stable in another porcine study using a MAC of less than 1(32). Malan et al studied the effects of sevoflurane on healthy volunteers and showed that systemic vascular resistance and mean pulmonary artery pressures are reduced(33).…”

mentioning

confidence: 99%

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: An echocardiography-based prospective observational study

Magunia¹,

Jordanow

Keller

et al. 2019

Preprint

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Background: General anesthesia induction with the initiation of positive pressure ventilation creates a vulnerable phase for patients. The impact of positive intrathoracic pressure on cardiac performance has been studied but remains controversial. 3D echocardiography is a valid and MRI-validated bed-side tool to evaluate the right ventricle (RV). The aim of this study was to assess the impact of anesthesia induction (using midazolam, sufentanil and rocuronium, followed by sevoflurane) with positive pressure ventilation (PEEP 5, tidal volume 6 – 8 ml/kg) on 2D and 3D echocardiography derived parameters of RV function. Methods: A prospective observational study on fifty-three patients undergoing elective cardiac surgery in a tertiary care university hospital was designed. Transthoracic echocardiography exams were performed before and immediately after anesthesia induction and were recorded together with hemodynamic parameters and ventilator settings. Results: After anesthesia induction TAPSE (mean difference -1.6mm (95% CI -2.6mm to -0.7mm; p=0.0013) as well as the Tissue Doppler derived tricuspid annulus peak velocity (TDITVs’) were significantly reduced (mean difference -1.9% (95% CI: -2.6 to -1.2; p<0.0001), but global right ventricular ejection fraction (RVEF; p=0.1607) and right ventricular stroke volume (RVSV; p=0.1838) did not change. Conclusions: This data shows a preserved right ventricular ejection fraction and right ventricular stroke volume after anesthesia induction and initiation of positive pressure ventilation. However, the baso-apical right ventricular function is significantly reduced. Larger studies are needed in order to determine the clinical impact of these findings especially in patients presenting with impaired right ventricular function before anesthesia induction. Trial registration: Retrospecitvely registered, 6th June 2016, ClinicalTrials.gov Identifier NCT02820727.

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Sevoflurane anesthesia during acute right ventricular ischemia in pigs preserves cardiac function better than propofol anesthesia

Abstract: Inhalation anesthesia with sevoflurane seems superior to intravenous anesthesia with propofol in acute right ventricular ischemic dysfunction.

Cited by 7 publications

References 41 publications

Downregulation of microRNA‐155 stimulates sevoflurane‐mediated cardioprotection against myocardial ischemia/reperfusion injury by binding to SIRT1 in mice

Downregulation of microRNA‐155 stimulates sevoflurane‐mediated cardioprotection against myocardial ischemia/reperfusion injury by binding to SIRT1 in mice

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: an echocardiography-based prospective observational study

The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: An echocardiography-based prospective observational study

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