Protective effect of myocardial preconditioning with propofoi and adenosine against ischemia-reperfusion injury in dog
- VernacularTitle:腺苷与异丙酚预处理对犬心肌缺血再灌注损伤的保护作用
- Author:
Jing WU
;
Shanglong YAO
;
Fangmin HUANG
- Publication Type:Journal Article
- Keywords:
Propofol;
Adenosine;
Myocardial reperfusion injury
- From:
Chinese Journal of Anesthesiology
1994;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the protective effect of myocardial preconditioning with propofol alone vs propofol and adenosine against ischemia-reperfusion (I/R) injury. Methods Twenty-one mongrel dogs of either sex weighing 11-16 kg were randomly divided into 3 groups ( n = 7 each) : group A I/R; group B propofol + I/R and group C propofol + adenosine + I/R. The animals were anesthetized with intramuscular ketamine and intermittent i.v. boluses of thiopental, intubated and mechanically ventilated. The chest was opened and the left anterior descending (LAD) artery was occluded for 60 min followed by 120 min reperfusion. In group B propofol was infused at 5.6 mg?kg-1?h-1 for 30 min before I/ R whereas in group C adenosine 0.1 mmol was injected at the root of aorta 10 min before I/R in addition to propofol infusion. Left cardiac catheter was placed in left ventricle via left common carotid artery for MAP and left ventricular pressure monitoring. ECG, BP, HR, CVP, left ventricular systolic and end-diastolic pressure (LVSP, LVEDP), left ventricular ejection fraction (EF) cardiac output (CO) and stroke volume (SV) were monitored. Coronary perfusion pressure (CPP= DBP - LVEDP) and heart rate-pressure product (RPP= HR?SBP) were calculated. Regional wall motion (RWM) of the ischemic myocardium was scored. Results Ischemic ECG changes ( S-T segment elevation, abnormal T and arrhythmia) developed immediately after occlusion of LAD artery. LVEDP was significantly increased while CO, SV, EF, CPP and RPP were significantly decreased after LAD artery was occluded as compared to the baseline values in group A. Preconditioning with propofol alone or propofol combined with adenosine attenuated the hemodynamic changes induced by I/R. RWM score was significantly increased after LAD artery occlusion and was significantly lower in group B and C than in group A.Conclusion Propofol preconditioning can protect myocardium against I/R injury but adenosine combined with propofol does not enhance the protective effect.