Effect of Ischemic Preconditioning and Propofol on Myocardial Protection in the Globally Ischemic-reperfused Isolated Rat Heart.
10.4097/kjae.2004.46.4.445
- Author:
Hae Wone CHANG
1
;
Choon Hak LIM
;
Sung Uk CHOI
;
Hye Won LEE
Author Information
1. Department of Anesthesiology, School of Medicine, The Catholic University of Korea, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
global ischemia;
ischemic preconditioning;
isolated heart;
propofol;
myocardial function;
rat
- MeSH:
Animals;
Cardiopulmonary Bypass;
Coronary Occlusion;
Creatinine;
Equidae;
Heart Transplantation;
Heart*;
Humans;
Ischemia;
Ischemic Preconditioning*;
Perfusion;
Phosphotransferases;
Propofol*;
Rats*;
Relaxation;
Reperfusion;
Ventricular Dysfunction
- From:Korean Journal of Anesthesiology
2004;46(4):445-453
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Although ischemic preconditioning (IPC) or propofol is generally known to confer the cardioprotective effect on ischemic-reperfused hearts, especially in patients subjected to operation such as cardiopulmonary bypass and heart transplantation, the exact effects of IPC and propofol are still controversial. Furthermore, the interaction between IPC- and propofol-induced cardioprotective effects has not been studied yet. The aims of this study are to examine 1) whether IPC and propofol demonstrates the cardioprotective effect against ischemic-reperfusion injury in the isolated rat hearts, and if so, 2) whether the combination of IPC and propofol shows the additive effects. METHODS: Isolated rat hearts were subjected to 30 min global ischemia followed by 60 min of reperfusion. Four groups of hearts (n = 7 per group) were studied. Group control (no intervention); group IPC, two 2-min total coronary occlusions (ischemic preconditioning) interspersed with 5 min and 6 min of normal perfusion before global ischemia; group propofol, propofol 2microgram/ml (11.1microM) administered before global ischemia and during reperfusion; group propofol/IPC, propofol 2microgram/ml administered before IPC and during reperfusion. Left ventricular developed pressure (LVDP), left ventricular end-diastolic pressure (LVEDP), + dP/dtmax and - dP/dtmin were recorded and creatinine kinase (CK) in coronary effluent perfusate and coronary flow also were measured. RESULTS: There were significant differences in recovery of postischemic systolic function between control and IPC, propofol and propofol/IPC as assessed by LVDP, expressed as a percentage of preischemic value (22.2 +/-8.4 vs 59.4 +/- 6.8, 69.4 +/- 7.9 and 66.0+/- 7.1%, respectively; P <0.05) at the end of reperfusion. The propofol and propofol/IPC showed better recovery in postischemic relaxation than IPC or control as asse ssed by LVEDP (11.3 +/- 2.2 and 11.3 +/-6.1 vs 56 +/- 6.0 or, 25.2 +/- 7.6 mmHg, respectively; P < 0.05). There were significant differences in attenuation of myocardial damage between propofol/IPC and control as assessed by % change of CK (135.5 +/- 54.7 vs 602.3 +/- 225.1%, P < 0.05) and % change of coronary flow (66.6 +/- 4.0 vs 39.2 +/-5.2%, P < 0.05). CONCLUSIONS: These results suggest that ischemic preconditioning combined with propofol may not show any additive effect on IPC-and propofol-induced attenuation of postischemic ventricular dysfunction, however it show the tendency to attenuate the myocardial damage.
