Cardioprotective Effects of Propofol and Sevoflurane in Ischemic and Reperfused Rat Hearts 

Abstract

HOE 642, propofol, and sevoflurane provide cardioprotection via different mechanisms. These distinct mechanisms may allow for the additive and superior protection observed with the combination of these anesthetics and HOE 642.

Cardioprotective effects of KB-R7943, a novel inhibitor of Na+/Ca2+ exchanger, on stunned myocardium in anesthetized dogs

“…NHE inhibitors have been extensively demonstrated to protect against the myocardial ischemia-reperfusion injury in terms of improved contractile dysfunction, reduction of infarct size, and antiarrhythmic effect in various experimental models and animal species [4,22,23]. Moreover, cariporide, a specific NHE inhibitor, has recently undergone clinical evaluation in high-risk patients with acute coronary syndrome, including those undergoing percutaneous or surgical revascularization [24].…”

The cardioprotective effect of microemulsion propofol against ischemia and reperfusion injury in isolated rat heart

“…In our study, we evaluated whether propofol emulsified with PP188, MP, had an additive or synergistic cardioprotective effect against ischemia-reperfusion injury. LP is known to have myocardial protective effect in the concentration range 25-100 µM (4.46-17.83 µg/ml) in isolated rat hearts [1,2,12]. Clinically, the recommended propofol concentration is 3-6 µg/ml for general anesthesia.…”

“…PP188 is incorporated into the lipid bilayers, thereby decreasing their susceptibility to oxidative stress and inflammation [7-11]. Inhaled anesthetics, propofol, and PP188 provide cardioprotection against ischemia and reperfusion injury via different mechanisms [11], but despite these distinct mechanisms several studies have demonstrated that no additive or superior protection was observed with the combination of these cardioprotective agents [12,13]. …”

Postconditioning of sevoflurane and propofol is associated with mitochondrial permeability transition pore

“…Anesthetic postconditioning, i.e., ischemic postconditioning, is elicited by anesthetic administration right at the onset of reperfusion, and is another promising therapeutic strategy of attaining myocardial protection against ischemia-reperfusion damage. Sevoflurane and propofol had been demonstrated to exert cardioprotection via many pathways during ischemia reperfusion (Javadov et al, 2000;Kokita et al, 1998;Mathur et al, 1999;Obal et al, 2003). However, whether their postconditioning is associated with MPTP is still unclear.…”

“…Nevertheless, it might not be the only mediator underlying the complicating pathological lesion (Zhao and Vinten-Johansen, 2006). Glyburide, a K ATP antagonist, pretreatment significantly attenuated the recovery of left ventricular developed pressure (LVDP), but did not abolish the cardioprotection observed with sevoflurane (Mathur et al, 1999). Taken together, the mechanism undergoing postconditioning of sevoflurane and propofol against referfusion injury is not well established.…”