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

Abstract

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

Emulsified Isoflurane Produces Cardioprotection against Severe Burn-Induced Cardiac Shock

“…EIso, an innovative formation of isoflurane, that enables an intravenous (rather than the traditional inhalation) route of administration for this anesthetic (5, 6), was shown to have similar cardioprotective effect as isoflurane does. For example, we and other researches have demonstrated that intravenous infusion of EIso could produce acute and delayed preconditioning or postconditioning against myocardial infarction in animals (7)(8)(9)(10)(11)(12). The current results also confirmed these previous findings demonstrating that in a rat model of severe burn injury, EIso could also protect hearts by decreasing serum levels of SOD and MDA and attenuating decreases in LVSP and dP/dtmax 2 to 3 hours post burn injury.…”

Can intralipid infusion open a coronary occlusion causing acute myocardial infarction?

“…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 [8]. It has been shown that inhaled isoflurane limits the size of myocardial infarcts.…”

Emulsified Isoflurane Preconditioning Protects Against Liver and Lung Injury in Rat Model of Hemorrhagic Shock

“…More recently, studies reported that preconditioning with emulsified isoflurane protects the hepatocyte and myocardium against I/R injury [10e13]. The mechanisms probably involved are the inhibition of cell death and improvement of the mitochondrial function [11,12]. Evidence indicates that emulsified isoflurane may be as effective as isoflurane in protecting the organs.…”