Anesthetic myocardial protection with sevoflurane

Nader, Nader D.; Li, Carlos M.; Khadra, Wiam Z.; Reedy, Roberta L.; Panos, Anthony L.

doi:10.1053/j.jvca.2004.03.004

Cited by 88 publications

(47 citation statements)

References 24 publications

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“…17,18,35 The observed attenuation of MMP-9 is unique since in contrast to neutrophil surface molecules involved in activation and adhesion such as integrins and selectins, MMP-9 is regulated at the level of tertiary granule release, a subgroup of the peroxidase-negative granules. 36,37 IL-8 stimulates the release of MMP-9 through activation of PKC, which in turn phosphorylates ERK1/2.…”

Section: Discussionmentioning

confidence: 99%

Volatile Anesthetics Reduce Invasion of Colorectal Cancer Cells through Down-regulation of Matrix Metalloproteinase-9

Müller‐Edenborn

Roth-Z'Graggen²,

Bartnicka³

et al. 2012

Anesthesiology

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Background Invasion of extracellular matrix is a hallmark of malignant tumors. Clamping maneuvers during cancer surgery reduce blood loss, but trigger reperfusion injury (RI). RI increases cancer recurrence in the reperfused organ through up-regulation of matrix metalloproteinase-9 (MMP-9). Interleukin-8 is an important cytokine in RI promoting accumulation of neutrophils, a major source of MMP-9. Volatile anesthetics were demonstrated to reduce RI. We hypothesized that these anesthetics might attenuate MMP-9 up-regulation and consequently tumor cell invasion in RI. Methods Isolated human neutrophils (n = 6) were preconditioned with sevoflurane or desflurane, followed by stimulation with interleukin-8, phorbol myristate acetate, or chemokine CXC-ligand 1 (CXCL1) to differentiate intracellular pathways. MMP-9 release and activity were quantified by enzyme-linked immunosorbent assay and zymography, respectively. CXC-receptor-2 (CXCR2) expression and phosphorylation of extracellular signal-regulated kinases 1/2 were assessed by flow cytometry. The impact of MMP-9 on the invasion of neutrophils and MC-38 colon cancer cells was assessed using Matrigel-coated filters (n = 6). Results Preconditioning reduced interleukin-8-induced MMP-9-release by 41% (±13, 5%, sevoflurane) and 40% (±13%, desflurane). This was also evident following stimulation of CXCR2 with CXCL1. No impact on phosphorylation of extracellular signal-regulated kinases 1/2 and MMP-9 release was observed with receptor-independent stimulation of protein kinase C with phorbol myristate acetate. Preconditioning reduced transmigration of neutrophils and MC-38 tumor cells to baseline levels. Discussion Volatile anesthetics impair neutrophil MMP-9 release and interfere with pathways downstream of CXCR2, but upstream of protein kinase C. Through down-regulation of MMP-9, volatile anesthetics decrease Matrigel breakdown and reduce subsequent migration of cancer cells in vitro.

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Section: Discussionmentioning

confidence: 99%

Volatile Anesthetics Reduce Invasion of Colorectal Cancer Cells through Down-regulation of Matrix Metalloproteinase-9

Müller‐Edenborn

Roth-Z'Graggen²,

Bartnicka³

et al. 2012

Anesthesiology

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“…7) However, in accordance with our findings in the current study, evidence from clinical studies shows that sevoflurane has superior cardioprotective effects than propofol in elderly patients undertaking coronary artery bypass surgery. [27][28][29][30][31] Similarly, experimental studies have demonstrated that anesthetic preconditioning and postconditioning induced by isoflurane, another volatile anesthetic commonly used in clinical anesthesia, retain anti-MIRI protection in infarct-remodeled rat hearts. 10,12) Taken together, it is highly possible that cardioprotection elicited by volatile anesthetics is more effective than ischemic conditioning in diseased myocardium.…”

Section: Discussionmentioning

confidence: 99%

Sevoflurane Postconditioning Protects Chronically-Infarcted Rat Hearts against Ischemia-Reperfusion Injury by Activation of Pro-survival Kinases and Inhibition of Mitochondrial Permeability Transition Pore Opening upon Reperfusion

Yao

Li³

et al. 2009

Biological & Pharmaceutical Bulletin

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“…Sevoflurane, a potent inhalation agent, decreases the inflammatory response and improves myocardial function after CPB (6). Dexmedetomidine, a selective and specific α-2 adrenoceptor agonist, has been frequently used as a sedative or adjuvant anesthetic drug in cardiac surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the cardioprotective effects of dexmedetomidineand remifentanil in cardiac surgery*

Türktan¹,

Güneş²,

Yaliniz³

et al. 2017

Turk J Med Sci

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IntroductionMyocardial protection is important in preventing the damaging effects of a cardiopulmonary bypass (CPB) on the myocardium, including ischemic and reperfusion injury (1). Eliminating or reducing myocardial injury can improve the clinical prognosis of patients undergoing cardiac surgery. Cardiac biomarkers are associated with the degree of cardiac injury and cardiac troponin I (cTnI), lactate, and creatine phosphokinase-MB (CKMB) are especially sensitive biomarkers for evaluating cardiac cell damage (2-4). Pyruvate, lactate, glucose, and insulin are respiratory substrates indicating heart perfusion. The level of pyruvate in the blood increases in the anaerobic state and pyruvate is converted to lactate under these conditions (3-5).Sevoflurane, a potent inhalation agent, decreases the inflammatory response and improves myocardial function after CPB (6). Dexmedetomidine, a selective and specific α-2 adrenoceptor agonist, has been frequently used as a sedative or adjuvant anesthetic drug in cardiac surgery. Dexmedetomidine has also been known to have some neuroprotective effects; however, data are insufficient for its cardioprotective effects in human studies. Remifentanil, a fast-acting opioid, has been generally used in cardiac surgery for cardiac protection before sternotomy (7).This study compared the cardiac effects of sevoflurane plus dexmedetomidine with those of sevoflurane plus remifentanil during adult cardiac surgery with CPB by examining levels of lactate, pyruvate, CKMB, and cTnI in patient blood samples. The hypothesis is that a difference Background/aim: Myocardial protection is an important factor of open heart surgery and biological biomarkers (lactate, CKMB, cardiac troponin I, and pyruvate) are used to assess myocardial damage. This study compares the effects of dexmedetomidine and remifentanil on myocardial protection during coronary artery bypass grafting (CABG) surgery. Materials and methods:Patients scheduled for elective CABG surgery (n = 60) were included in this study. Anesthesia induction was introduced with propofol, fentanyl, and vecuronium bromide. Anesthesia was maintained with remifentanil infusion and sevoflurane in the remifentanil group (Group R) and with dexmedetomidine infusion and sevoflurane in the dexmedetomidine group (Group D). Blood samples for biochemical markers were taken from the coronary sinus catheter before cardiopulmonary bypass (T1), 20 min after aortic cross-clamping (T2), 20 min after removal of the aortic cross-clamping (T3), and 10 min after separation from cardiopulmonary bypass (T4).Results: Demographic data were similar between the groups. Lactate level at the T2 period and CKMB levels during the study period were lower in Group D than in Group R. In both groups, all values except pyruvate significantly increased over time. Conclusion:The dexmedetomidine-sevoflurane combination may improve the cardioprotective effect in comparison with remifentanilsevoflurane in CABG surgery.

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Anesthetic myocardial protection with sevoflurane

Cited by 88 publications

References 24 publications

Volatile Anesthetics Reduce Invasion of Colorectal Cancer Cells through Down-regulation of Matrix Metalloproteinase-9

Volatile Anesthetics Reduce Invasion of Colorectal Cancer Cells through Down-regulation of Matrix Metalloproteinase-9

Sevoflurane Postconditioning Protects Chronically-Infarcted Rat Hearts against Ischemia-Reperfusion Injury by Activation of Pro-survival Kinases and Inhibition of Mitochondrial Permeability Transition Pore Opening upon Reperfusion

Comparison of the cardioprotective effects of dexmedetomidineand remifentanil in cardiac surgery*

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