Sevoflurane preconditions stunned myocardium in septic but not healthy isolated rat hearts

R. Serita, Hiroshi Morisaki, K. Ai, Y. Morita, Y. Innami, T. Satoh, Shizuko Kosugi, Y. Kotake, J. Takeda

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Abstract

Background. Recent evidence indicates that sevoflurane treatment before prolonged ischaemia reduces infarct size in normal hearts, mimicking ischaemic preconditioning. We examined whether exposure to sevoflurane before brief ischaemia, inducing a 'stunned myocardium', provided such protective effects in an isolated working heart from normal or septic rats. Methods. With institutional approval, 91 rats were randomly allocated into one of either caecal-ligation and perforation (CLP: n=50) or sham (Sham: n=41) procedure groups 24 h before the study. After determination of baseline measurements, including cardiac output (CO), myocardial oxygen consumption (mVO2) and cardiac efficiency (CE; COpeak systolic pressure/mVO2), each isolated heart was perfused with or without 2% sevoflurane for 15 min before global ischaemia (pre-ischaemia). After 15 min ischaemia and 30 min reperfusion, all hearts were assessed for functional recovery of myocardium (post-reperfusion). Results. During the pre-ischaemia period, 2% sevoflurane caused a significant reduction of CO in the CLP group compared with the Sham group. During the post-reperfusion period, both CO (16.9 vs 11.0 ml min-1) and CE (11.2 vs 7.7 mm Hg ml-1 (μI O2)-1) was higher in the sevoflurane-treated vs -untreated hearts from CLP rats, and was accompanied by lower incidence of reperfusion arrhythmia compared with control hearts (8 vs 32%). In contrast, 2% sevoflurane did not provide cardioprotective effects in normal rats. Conclusions. The current study demonstrates that pre-treatment with sevoflurane minimizes myocardial dysfunction and the incidence of reperfusion arrhythmia after brief ischaemic insults in septic hearts.

Original languageEnglish
Pages (from-to)896-903
Number of pages8
JournalBritish Journal of Anaesthesia
Volume89
Issue number6
DOIs
Publication statusPublished - 2002 Dec 1

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Keywords

  • Anaesthetics volatile, sevoflurane
  • Heart, reperfusion arrhythmia
  • Infection, sepsis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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