Document Detail


Levosimendan cardioprotection in acutely beta-1 adrenergic receptor blocked open chest pigs.
MedLine Citation:
PMID:  19681782     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Levosimendan and volatile anesthetics have myocardial pre-conditioning effects. beta-1 adrenergic receptor antagonists may inhibit the protective effect of volatile anesthetics. No information exists as to whether this also applies to the pre-conditioning effect of levosimendan. We therefore investigated whether levosimendan added to metoprolol would demonstrate a cardioprotective effect. METHODS: Three groups of anesthetized open chest pigs underwent 30 min of myocardial ischemia and 90 min of reperfusion by temporary occlusion of the largest side branch from the circumflex artery or the left anterior descending artery. One group (CTRL) served as a control, in another group (BETA), a metoprolol-loading dose was intravenously injected 30 min before ischemia, and in a third group (BETA+L), a levosimendan infusion was added to metoprolol. Myocardial tissue concentrations of glucose, glycerol, and lactate/pyruvate ratio as the primary end-points were investigated with microdialysis in ischemic and non-ischemic tissues. RESULTS: At the end of the ischemic period, statistically significant differences were only found between CTRL and BETA+L in the ischemic myocardium, with a lower lactate/pyruvate ratio, lower glycerol, and higher glucose concentrations in BETA+L as compared with CTRL. There were no differences in non-ischemic myocardium. From 10 to 90 min of reperfusion, no more differences were found between groups. CONCLUSION: The cardioprotective effect of levosimendan on ischemic metabolism with a reduction in the myocardial lactate/pyruvate ratio, less glycerol accumulation, and better preserved glucose concentration does not seem to be prevented by beta-1 adrenergic receptor antagonism with metoprolol.
Authors:
C Metzsch; R Linn?r; S Steen; Q Liao; L Algotsson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-13
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  54     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-07     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  103-10     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Lund University, Lund, Sweden. carsten.metzsch@med.lu.se
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / administration & dosage
Animals
Cardiotonic Agents / administration & dosage*
Clinical Protocols
Female
Glucose / analysis
Glycerol / analysis
Hemodynamics / drug effects
Hydrazones / administration & dosage*
Lactic Acid / analysis
Male
Metoprolol / administration & dosage
Microdialysis
Myocardial Ischemia / drug therapy*,  metabolism
Myocardial Reperfusion Injury / prevention & control*
Pyridazines / administration & dosage*
Pyruvic Acid / analysis
Swine
Thoracic Surgical Procedures / methods*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 127-17-3/Pyruvic Acid; 131741-08-7/simendan; 37350-58-6/Metoprolol; 50-21-5/Lactic Acid; 50-99-7/Glucose; 56-81-5/Glycerol

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


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