| English |
|---|
| Title | Isoflurane Preserves ATP in Stunned Canine Heart without Depending on the Reduction in Cardiac Work |
|---|
| Subtitle | |
|---|
| Authors | Noriaki Kanaya, Yuri Nakae, Iwao Kobayashi, Masayasu Nakayama, Satoshi Fujita, Akiyoshi Namiki |
|---|
| Authors(kana) | |
|---|
| Organization | Department of Anesthesiology, School of Medicine, Sapporo Medical University |
|---|
| Journal | Circulation Control |
|---|
| Volume | 16 |
|---|
| Number | 4 |
|---|
| Page | 520-526 |
|---|
| Year/Month | 1995/ |
|---|
| Article | Original article |
|---|
| Publisher | Japan Society of Circulation Control |
|---|
| Abstract | uAbstractvSustained dysfunction of myocardial contractility following short periods of coronary artery occlusion and reperfusion is termed gstunned myocardiumh. Isoflurane may improve the recovery of regional myocardial contractility in stunned myocardium. The purpose of the present study was to determine whetherF1) isoflurane improves the regional myocardial contractility, 2) isoflurane prevents depletion of high energy phosphates (HEP)Gand 3) the relief in cardiac work during isoflurane anesthesia contributes to the preservation of the HEP metabolism in stunned myocardium in an acute canine model. The left anterior descending coronary artery (LAD) was occluded for 15 min and then reperfused for 60 min under isoflurane (1.5 % endtidal concentration) anesthesia. Regional myocardial contraction was evaluated by ultrasonic segment shortening (SS), and postsystolic shortening (PSS) measurements. In another group, mongrel dogs were allocated into three groupsFControls, anesthetized with urethane and chloraloseGthe ISO group, given isoflurane before ischemiaGand the ISOc group, whose heart rate and mean blood pressure were controlled to approximately match baseline values. Full thickness samples of myocardium were obtained from the reperfused area (supplied by the LAD) and the non-ischemic area (supplied by the left circumflex coronary artery). The levels of adenosine monophosphate, adenosine diphosphate, adenosine triphosphate (ATP), creatine phosphate, and lactate in the endocardial portion of the myocardium were measured. After 60 min of reperfusion, percent SS was 67.7}6.6 % vs 23.9}9.4 %, isoflurane and control, respectivelyGPSS was 10.5}4.6 % isoflurane vs 40.5}8.8 % control. Although ATP of the reperfused area in the control group showed significantly lower levels 60 min after reperfusion, the ISO and ISOc groups preserved significantly higher levels of ATP than the control group. In conclusion, after a brief period (15 min) of myocardial ischemia followed by 60 min reperfusion, isoflurane improved the regional myocardial contractility, and resulted in higher myocardial ATP than the control groups even when the cardiac work was restored to near baseline values. The relief in cardiac work plays only a minor role in the ATP-sparing effect of isoflurane. |
|---|
| Practice | Basic medicine |
|---|
| Keywords | Stunned Myocardium, Isoflurane, Contractility, ATP |
|---|