Delta opioid receptors and low temperature myocardial protection

Schwartz, Charles; Georges, A; Gallagher, M.; Yu, Le; Kilgore, Kenneth S.; Bolling, Steven F.

doi:10.1016/s0003-4975(99)01165-0

Cited by 14 publications

(4 citation statements)

References 19 publications

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“…We have shown earlier that both a plasma fraction from hibernating animals (hibernation induction trigger) and the selective δ-opioid receptor agonist DADLE similarly improve protection in animal models of multiorgan autoperfusion and cardioplegic arrest. 15,16 The observation that opioid receptor antagonists such as naloxone or naltrexone reverse these changes supported the hypothesis that peripheral opioid receptors are involved in signal transduction occurring during natural hibernation. 17 Subsequent studies in various experimental models revealed that natural and "artificial" hibernation induction triggers such as DADLE improve organ protection in experimental models relevant to clinical cardiac surgery, including heart and lung transplantation.…”

Section: Discussionmentioning

confidence: 75%

Myocardial protection by ischemic preconditioning and δ-opioid receptor activation in the isolated working rat heart

Kretzler

Tanaka

Bolling

et al. 2001

The Journal of Thoracic and Cardiovascular Surgery

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Pharmacologic activation of delta-opioid receptors affords improvement of functional protection in isolated working rat hearts similar to that conferred by classic ischemic preconditioning. The combination of both pretreatments reduces ischemic cellular damage and further adds to postischemic functional recovery. These changes are reversed by naloxone, an observation providing evidence that ischemic preconditioning involves signaling through opioid receptors.

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Section: Discussionmentioning

confidence: 75%

Myocardial protection by ischemic preconditioning and δ-opioid receptor activation in the isolated working rat heart

Kretzler

Tanaka

Bolling

et al. 2001

The Journal of Thoracic and Cardiovascular Surgery

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“…Morphine, pentazocine and buprenorphine improved mechanical function after global total ischemia for two hours at 34°C. 65,68 Opioids also elicited a protective effect in heart preservation at 4 or 10°C for four to18 hr; [68][69][70] this might be an indication of the usefulness of opioids in heart transplantation. 6 6.…”

Section: Energy Metabolismmentioning

confidence: 93%

“…Pentazocine and buprenorphine improved postischemic contractility in rabbits in vitro. 65,68 Overall, the effects of opioids other than morphine have not been sufficiently investigated to allow conclusions to be drawn.…”

Section: Energy Metabolismmentioning

confidence: 99%

Myocardial protection by anesthetic agents against ischemia-reperfusion injury: An update for anesthesiologists

Kato

Foëx

2002

Can J Anesth/J Can Anesth

197

126

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P Pu ur rp po os se e: : The aim of this review of the literature was to evaluate the effectiveness of anesthetics in protecting the heart against myocardial ischemia-reperfusion injury.S So ou ur rc ce e: : Articles were obtained from the Medline database (1980-, search terms included heart, myocardium, coronary, ischemia, reperfusion injury, infarction, stunning, halothane, enflurane, desflurane, isoflurane, sevoflurane, opioid, morphine, fentanyl, alfentanil sufentanil, pentazocine, buprenorphine, barbiturate, thiopental, ketamine, propofol, preconditioning, neutrophil adhesion, free radical, antioxidant and calcium).P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Protection by volatile anesthetics, morphine and propofol is relatively well investigated. It is generally agreed that these agents reduce the myocardial damage caused by ischemia and reperfusion. Other anesthetics which are often used in clinical practice, such as fentanyl, ketamine, barbiturates and benzodiazepines have been much less studied, and their potential as cardioprotectors is currently unknown. There are some proposed mechanisms for protection by anesthetic agents: ischemic preconditioning-like effect, interference in the neutrophil/platelet-endothelium interaction, blockade of Ca 2+ overload to the cytosolic space and antioxidant-like effect. Different anesthetics appear to have different mechanisms by which protection is exerted. Clinical applicability of anesthetic agent-induced protection has yet to be explored. C Co on nc cl lu us si io on n: : There is increasing evidence of anesthetic agentinduced protection. At present, isoflurane, sevoflurane and morphine appear to be most promising as preconditioning-inducing agents. After the onset of ischemia, propofol could be selected to reduce ischemia-reperfusion injury. Future clinical application depends on the full elucidation of the underlying mechanisms and on clinical outcome trials. Objectif

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“…28 6-Opioid receptor agonists could improve myocardial recovery following global ischemia over the wide range of temperatures in a nonhibernating mammalian model. 29 Diadenosine tetraphosphate had cardioprotective proprieties without apparent side effects when tested on rat hearts. 30 Pinacidil, an activator of the adenosinetriphosphate potassium channel, extends ischemia tolerance of neonatal rabbits hearts.31…”

Section: New Methods Of Myocardial Protection (Future Considerations)mentioning

confidence: 99%

Myocardial Protection During Minimally Invasive Cardiac Surgery

Dobkowski¹

2002

Semin Cardiothorac Vasc Anesth

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Minimally invasive cardiac surgery or beating heart surgery requires very precise observation, explanation, diagnosis, and proper treatment of all changes in the cardiovascular system that occur during the procedure. A major concern in beating heart surgery is the risk of inducing myocardial ischemia without the circulatory support of cardiopulmonary bypass. Protection of myocardium in different stages of the perioperative period is crucial. The following issues should be taken into consideration: preoperative preparation of the myocardium, providing anesthesia techniques that may help to protect the myocardium, and the use of surgical techniques for myocardial protection. Hemodynamic alterations during dislocations of the heart require understanding of these changes and the effects they have on the myocardium. Proper monitoring during the whole procedure, correlation of all findings with the treatment and therapeutic maneuvers, and excellent cooperation between anesthesiologist and surgeon are essential for myocardial protection. New pharmacologic methods, some experimental, should be considered in near future for myocardial protection during beating heart surgery.

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Delta opioid receptors and low temperature myocardial protection

Cited by 14 publications

References 19 publications

Myocardial protection by ischemic preconditioning and δ-opioid receptor activation in the isolated working rat heart

Myocardial protection by ischemic preconditioning and δ-opioid receptor activation in the isolated working rat heart

Myocardial protection by anesthetic agents against ischemia-reperfusion injury: An update for anesthesiologists

Myocardial Protection During Minimally Invasive Cardiac Surgery

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