Document Detail


Hyperglycemia prevents isoflurane-induced preconditioning against myocardial infarction.
MedLine Citation:
PMID:  11753019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Volatile anesthetics stimulate but hyperglycemia attenuates activity of mitochondrial adenosine triphosphate-regulated potassium channels. The authors tested the hypothesis that acute hyperglycemia interferes with isoflurane-induced preconditioning in vivo. METHODS: Barbiturate-anesthetized dogs (n = 79) were instrumented for measurement of hemodynamics. Myocardial infarct size and collateral blood flow were assessed with triphenyltetrazolium chloride staining and radioactive microspheres, respectively. All dogs were subjected to a 60-min left anterior descending coronary artery occlusion followed by 3 h of reperfusion. Dogs were randomly assigned to receive an infusion of normal saline (normoglycemic controls) or 15% dextrose in water to increase blood glucose concentrations to 300 or 600 mg/dl in the absence or presence of isoflurane (0.5 or 1.0 minimum alveolar concentration [MAC]) in separate experimental groups. Isoflurane was discontinued, and blood glucose concentrations were allowed to return to baseline values before left anterior descending coronary artery occlusion. RESULTS: Myocardial infarct size was 26 +/- 1% of the left ventricular area at risk in control experiments. Isoflurane reduced infarct size (15 +/- 2 and 13 +/- 1% during 0.5 and 1.0 MAC, respectively). Hyperglycemia alone did not alter infarct size (26 +/- 2 and 33 +/- 4% during 300 and 600 mg/dl, respectively). Moderate hyperglycemia blocked the protective effects of 0.5 MAC (25 +/- 2%) but not 1.0 MAC isoflurane (13 +/- 2%). In contrast, severe hyperglycemia prevented reductions of infarct size during both 0.5 MAC (29 +/- 3%) and 1.0 MAC isoflurane (28 +/- 4%). CONCLUSIONS: Acute hyperglycemia attenuates reductions in myocardial infarct size produced by isoflurane in dogs.
Authors:
Franz Kehl; John G Krolikowski; Boris Mraovic; Paul S Pagel; David C Warltier; Judy R Kersten
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Anesthesiology     Volume:  96     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2001-12-25     Completed Date:  2002-02-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Medical College of Wisconsin and Zablocki VA Medical Center, Milwaukee, 53226, USA.
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Inhalation / pharmacology*
Animals
Dogs
Female
Hemodynamics / drug effects
Ischemic Preconditioning*
Isoflurane / pharmacology*
Male
Myocardial Infarction / prevention & control*
Grant Support
ID/Acronym/Agency:
AA 12331/AA/NIAAA NIH HHS; GM 08377/GM/NIGMS NIH HHS; HL 03690/HL/NHLBI NIH HHS; HL 54280/HL/NHLBI NIH HHS; HL 63705/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 26675-46-7/Isoflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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