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Effects of propofol on the systolic and diastolic performance of the postischaemic, reperfused myocardium in rabbits

Published online by Cambridge University Press:  02 June 2005

H. A. Leather ,
M. H. De Wolff  and
P. F. Wouters
H. A. Leather
Affiliation:
Katholieke Universiteit Leuven, Department of Anaesthesiology and Centre for Experimental Surgery and Anaesthesiology, Leuven, Belgium
M. H. De Wolff
Affiliation:
Katholieke Universiteit Leuven, Department of Anaesthesiology and Centre for Experimental Surgery and Anaesthesiology, Leuven, Belgium
P. F. Wouters
Affiliation:
Katholieke Universiteit Leuven, Department of Anaesthesiology and Centre for Experimental Surgery and Anaesthesiology, Leuven, Belgium
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Extract

Summary

Background and objective: The effect of propofol on myocardial dysfunction during ischaemia and reperfusion is controversial yet important because of its frequent use in cardiac anaesthesia. Although animal studies suggest a free radical-scavenging potential, the cardioprotective properties of propofol have not been demonstrated consistently in vivo. Previous studies focused on systolic function while diastolic function may be a more sensitive marker of ischaemic injury. The main aim was to document the effect of propofol on diastolic function in isolated, blood perfused rabbit hearts subjected to moderate global ischaemia and reperfusion.

Methods: Propofol 168 μmol L−1, or the equivalent of its vehicle, Intralipid®, was administered to 34 paced parabiotic Langendorff blood-perfused isolated rabbit hearts before and after 30 min of global normothermic ischaemia. Recovery of systolic function was quantified with the maximum rate of rise of left ventricular pressure. Diastolic performance was assessed using the time constant of the decline in left ventricular pressure (τ) and chamber stiffness (VdP/dV at 12 mmHg).

Results: Recovery of systolic function during reperfusion was comparable in the two groups. There was no difference in left ventricular pressure between the two groups at any time during the experiments. Chamber stiffness increased significantly during ischaemia and reperfusion in the control group (from 34 ± 9 to 54 ± 8 mmHg during ischaemia, and 43 ± 5 mmHg after 30 min reperfusion; mean ±95% confidence interval) but not in the propofol-treated group (29 ± 5, 36 ± 8 and 30 ± 8 at baseline, ischaemia and 30 min reperfusion, respectively).

Conclusions: Propofol has no protective effect on active relaxation or on systolic function in the present model, but it reduces ischaemic and postischaemic chamber stiffness.

Keywords

ANAESTHETICS, INTRAVENOUS, propofolCARDIOVASCULAR DISEASES, ischaemia, myocardial ischaemia, myocardial stunning, vascular diseasesCARDIOVASCULAR PHYSIOLOGY, ventricular function, ventricular function, left
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 3 , March 2003 , pp. 191 - 198
Copyright
© 2003 European Society of Anaesthesiology

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References

Warltier DC, al-Withiqui MH, Kampine JP, Schmeling WT. Recovery of contractile function of stunned myocardium in chronically instrumented dogs is enhanced by halothane or isoflurane. Anesthesiology 1988; 69: 552–565.Google Scholar
Toller WG, Gross ER, Kersten JR, et al. Sarcolemmal and mitochondrial adenosine triphosphate-dependent potassium channels: mechanism of desflurane-induced cardioprotection. Anesthesiology 2000; 92: 1731–1739.Google Scholar
Kokita N, Hara A. Propofol attenuates hydrogen peroxide-induced mechanical and metabolic derangements in the isolated rat heart. Anesthesiology 1996; 84: 117–127.Google Scholar
Ko SH, Yu CW, Lee SK, et al. Propofol attenuates ischemia– reperfusion injury in the isolated rat heart. Anesth Analg 1997; 85: 719–724.Google Scholar
Kokita N, Hara A, Abiko Y, Arakawa J, Hashizume H, Namiki A. Propofol improves functional and metabolic recovery in ischemic reperfused isolated rat hearts. Anesth Analg 1998; 86: 252–258.Google Scholar
Ross S, Munoz H, Piriou V, Ryder WA, Foëx P. A comparison of the effects of fentanyl and propofol on left ventricular contractility during myocardial stunning. Acta Anaesthesiol Scand 1998; 42: 23–31.Google Scholar
Meissner A, Weber TP, Van Aken H, Zbieranek K, Rolf N. Recovery from myocardial stunning is faster with desflurane compared with propofol in chronically instrumented dogs. Anesth Analg 2000; 91: 1333–1338.Google Scholar
Ebel D, Schlack W, Comfère T, Preckel B, Thamer V. Effect of propofol on reperfusion injury after regional ischaemia in the isolated rat heart. Br J Anaesth 1999; 83: 903–908.Google Scholar
Mathur S, Farhangkhgoee P, Karmazyn M. Cardioprotective effect of propofol and sevoflurane in ischemic and reperfused rat hearts: role of Katp channels and interaction with the sodium–hydrogen exchange inhibitor HOE 642 (Cariporide). Anesthesiology 1999; 91: 1349–1360.Google Scholar
Javadov SA, Lim KH, Kerr PM, et al. Protection of hearts from reperfusion injury by propofol is associated with inhibition of the mitochondrial permeability transition. Cardiovasc Res 2000; 45: 360–369.Google Scholar
Moreyra AE, Gelpi RJ, Mosca SM, Cingolani HE. Chronic administration of nicardipine attenuates myocardial stunning in isolated rabbit hearts. J Mol Cell Cardiol 1994; 26: 979–984.Google Scholar
Chen CC, Morishige N, Masuda M et al. R56865, a Na+- and Ca2+-overload inhibitor, reduces myocardial ischemia– reperfusion injury in blood-perfused rabbit hearts. J Mol Cell Cardiol 1993; 25: 1445–1459.Google Scholar
Van de Velde M, DeWolff M, Leather HA, Wouters PF. Effects of lipids on the functional and metabolic recovery from global myocardial stunning in isolated rabbit hearts. Cardiovasc Res 2000; 48: 129–137.Google Scholar
Mosca SM, Gelpi RJ, Cingolani HE. Dissociation between myocardial relaxation and diastolic stiffness in the stunned heart: its prevention by ischemic preconditioning. Mol Cell Biochem 1993; 129: 171–178.Google Scholar
Raff GL, Glantz SA. Volume loading slows left ventricular isovolumic relaxation rate. Evidence of load-dependent relaxation in the intact dog heart. Circ Res 1981; 48: 813–824.Google Scholar
Mirsky I. Assessment of diastolic function: suggested methods and future considerations. Circulation 1984; 69: 836–841.Google Scholar
Yoo KY, Yang SY, Lee J, et al. Intracoronary propofol attenuates myocardial but not coronary endothelial dysfunction after brief ischaemia and reperfusion in dogs. Br J Anaesth 1999; 82: 90–96.Google Scholar
Mazoit JX, Samii K. Binding of propofol to blood components: implications for pharmacokinetics and for pharmacodynamics. Br J Clin Pharmacol 1999; 47: 35–42.Google Scholar
Van Klarenbosch J, Stienen GJ, de Ruijter W, Scheffer GJ, de Lange JJ. The differential effect of propofol on contractility of isolated myocardial trabeculae of rat and guinea-pig. Br J Pharmacol 2001; 132: 742–748.Google Scholar
Graham MR, Thiessen DB, Mutch WC. Left ventric-ular systolic and diastolic function is unaltered during propofol infusion in newborn swine. Anesth Analg 1998; 86: 717–723.Google Scholar
Pagel PS, Schmeling WT, Kampine JP, Warltier DC. Alteration of canine left ventricular diastolic function by intravenous anesthetics in vivo. Ketamine and propofol. Anesthesiology 1992; 76: 419–425.Google Scholar
Kunichika H, Katayama K, Sakai H, Yonezawa T, Matsuzaki M. The effect of left ventricular chamber compliance on early diastolic filling during coronary reperfusion. Jpn Circ J 1995; 59: 762–771.Google Scholar
Bolli R, Marban E. Molecular and cellular mechanisms of myocardial stunning. Physiol Rev 1999; 79: 609–634.Google Scholar
Green TR, Bennet SR, Nelson VM. Specificity and properties of propofol as an antioxidant free radical scavenger. Toxicol Appl Pharmacol 1994; 129: 163–169.Google Scholar
Cook DJ, Housmans PR. Mechanism of the negative inotropic effect of propofol in isolated ferret ventricular myocardium. Anesthesiology 1994; 80: 859–871.Google Scholar
Yang CY, Wong CS, Yu CC, Luk HN, Lin CI. Propofol inhibits cardiac L-type calcium current in guinea pig ventricular myocytes. Anesthesiology 1996; 84: 626–635.Google Scholar
Kanaya N, Murray PA, Damron DS. Propofol and ketamine only inhibit intracellular Ca2+ transients and contraction in rat ventricular myocytes at supraclinical concentrations. Anesthesiology 1998; 88: 781–791.Google Scholar
Kanaya N, Murray PA, Damron DS. Propofol increases myofilament Ca+ sensitivity and intracellular pH via activation of Na+–H+ exchange in rat ventricular myocytes. Anesthesiology 2001; 94: 1096–1104.Google Scholar
Wouters PF, Van de Velde M, Van Aken H, Flameng W. Ischemic event characteristics determine the extent of myocardial stunning in conscious dogs. Basic Res Cardiol 1996; 91: 140–146.Google Scholar
Zhou W, Fontenot HJ, Liu S, Kennedy RH. Modulation of cardiac calcium channels by propofol. Anesthesiology 1997; 86: 670–675.Google Scholar
Mullenheim J, Molojavyi A, Preckel B, Thamer V, Schlack W. Thiopentone does not block ischemic preconditioning in the isolated rat heart. Can J Anaesth 2001; 48: 784–789.Google Scholar
Kato R, Ross S, Foëx P. Fentanyl protects the heart against ischaemic injury via opioid receptors, adenosine A1 receptors and KATP channel linked mechanisms in rats. Br J Anaesth 2000; 84: 204–214.Google Scholar