Effect of Methylprednisolone on Metabolism and Contractility in the Stunned Myocardium

Abstract

The effect of glucocorticoid on the metabolism and contractility in the stunned myocardium was examined by phosphorus 31 nuclear magnetic resonance (31P-NMR) in Langendorff rabbit hearts by use of an artificial blood substitute, perfluorochemical emulsion Flusol-43. After normothermic global ischemia of fifteen minutes, postischemic reperfusion of sixty-five minutes was carried out. Methylprednisolone sodium succinate (MPSS) was administered either prior to global ischemia or during postischemic reperfusion. Adenosine triphosphate (ATP), creatine phosphate (CrP), inorganic phosphate (Pi), pH, left ventricular systolic developed pressure (LV DevP) and coronary flow were continuously measured. Thirty-six hearts were divided into three experimental groups consisting of 12 hearts each; CONT consisted of controls, Pre-MPSS perfusion with MPSS-containing solution (10(-4)M) from forty-five minutes prior to global ischemia, and Post-MPSS with the same MPSS solution immediately after postischemic reperfusion. Pre-MPSS showed a significant inhibition of the increase in Pi and of the decrease in ATP and pH during global ischemia, in comparison with the other groups, and a suppression of the overshoot of CrP observed immediately after postischemic reperfusion. LV DevP of Pre-MPSS showed a marked improvement during the postischemic reperfusion as compared with CONT. In Post-MPSS, Pi was significantly increased and ATP decreased during the postischemic reperfusion as compared with the other two groups. There were no differences in coronary flow during postischemic reperfusion among the three groups. In conclusion MPSS has a beneficial effect on metabolism and contractility of the stunned myocardium when it is administered prior to ischemia.

Intratympanic corticosteroids injections: a systematic review of literature

“…Patients were selected for having Zhou et al [18] found that combination therapy was superior to systemic steroids alone for patients exposed to noise trauma who had shown no spontaneous recovery within the first 72 h. Eighty-one percent of the recruited patients had been exposed to fireworks or military training noise. The therapeutic effects of steroids are thought to arise from their protective effects on injured cells [31,32] by stabilization of cellular membranes, scavenging of oxygen free radicals and by inhibition of phospholipase A 2 . This first human study on ITSI therapy for NIHL shows promising results.…”

Primary Observation of Early Transtympanic Steroid Injection in Patients with Delayed Treatment of Noise-Induced Hearing Loss

“…Thus, it is generally considered that the following actions of glucocorticoids, through both genomic and nongenomic pathways, exert protective effects on injured cells [Hall, 1992;Kawabata et al, 1995]: (1) stabilization of cellular membranes, (2) scavenging of oxygen free radicals and inhibition of lipid peroxidation, and (3) inhibition of phospholipase A2 (inhibition of lipid hydrolysis, arachidonic acid release, and eicosanoid formation). These pharmacological actions of glucocorticoids might account for their protective effects on acoustic injury.…”

Inflammation in Coronary Artery Disease and Acute Myocardial Infarction - is the Stage Set for Novel Therapies?

“…Methotrexate therapy was neutral in that registry [55]. The observation that TNF-antagonists reduce risk is in line with the fact that the TNF-antibody infliximab improves endothelial function in patients with rheumatoid arthritis [56] Early experimental data on glucocorticoid treatment showed beneficial effects on post-infarct remodeling and ischemiareperfusion injury [57][58][59][60], whereas more recently, glucocorticoids were documented to increase infarct size through their mineralocorticoid effects in the heart [61]. Altogether those data may discourage the evaluation of prednisone for treatment of AMI in patients.…”