Document Detail


Pre-occlusion ischaemia, not sevoflurane, successfully preconditions the myocardium against further damage in porcine in vivo hearts.
MedLine Citation:
PMID:  17378777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sevoflurane is proposed to possess important tissue protective effects based on experimental ischaemia-reperfusion studies from models with collateral coronary flow, unlike that of the normal human or the porcine heart. The objective was to evaluate the infarct-reducing capability of pre-ischaemic sevoflurane inhalation on myocardial infarct size in a porcine model. METHODS AND MATERIALS: The study comprised 33 pigs under pentobarbital anaesthesia. Animals were divided into three groups: control (CON), sevoflurane intervention (SEVO) and ischaemic preconditioning (IP). The distal left anterior descending coronary artery was occluded for 40 min with a percutaneous coronary intervention catheter. Before occlusion, group IP underwent two 5-min ischaemia cycles, whereas SEVO received two 5-min sevoflurane 4%v/v inhalation cycles. Animals were reperfused for 150 min. We then measured risk area (AAR) and infarct size (IS) after tetrazolium staining. The [IS/AAR-ratio] was calculated. Haemodynamics and transthoracic tissue-Doppler echocardiography were monitored. RESULTS: Control animals developed a myocardial infarction in 46.4 (+/- 6.2)% (mean +/- SEM) of the AAR. Both SEVO and IP groups had infarction mitigated, to 34.4 (5.7)% and 23.1 (5.3)%, respectively; however, only in the IP group was this significant. No significant differences between groups with respect to AAR, haemodynamics or echocardiographic variables were found. CONCLUSION: Pre-ischaemic sevoflurane was found to reduce the extent of myocardial necrosis, but the change was not significant, whereas IP reduced IS by 50% (P= 0.038). Cardioprotection is species related and no previous results from porcine models have found sevoflurane to reduce IS. Anaesthetic washout, insufficient exposure or collateral coronary blood supply, dissimilar to human, may account for positive results in rodent models.
Authors:
J R Larsen; S R Aagaard; J M Hasenkam; E Sloth
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  51     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-23     Completed Date:  2007-07-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  402-9     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark. jens.rolighed@ki.au.dk
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MeSH Terms
Descriptor/Qualifier:
Anesthetics, Inhalation / pharmacology*
Animals
Blood Pressure / drug effects
Cardiotonic Agents / administration & dosage
Coronary Circulation / drug effects
Disease Models, Animal
Female
Heart Rate / drug effects
Ischemic Preconditioning / methods*
Methyl Ethers / pharmacology*
Myocardial Infarction / prevention & control*
Necrosis / prevention & control
Severity of Illness Index
Swine
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Cardiotonic Agents; 0/Methyl Ethers; 28523-86-6/sevoflurane

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