Postconditioning of sevoflurane and propofol is associated with mitochondrial permeability transition pore |
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| Authors: | He Wei Zhang Feng-jiang Wang Shao-ping Chen Gang Chen Cong-cong Yan Min |
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| Institution: | [1]Department of Anesthesiology, the SecondAffiliatedHospital, School of Medicine, Zhejiang University, Hangzhou 310009, China [2]Department of Cardiology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China |
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| Abstract: | Background: Sevoflurane and propofol are effective cardioprotective anaesthetic agents, though the cardioprotection of propofol
has not been shown in humans. Their roles and underlying mechanisms in anesthetic postconditioning are unclear. Mitochondrial
permeability transition pore (MPTP) opening is a major cause of ischemia-reperfusion injury. Here we investigated sevoflurane-and
propofol-induced postconditioning and their relationship with MPTP. Methods: Isolated perfused rat hearts were exposed to
40 min of ischemia followed by 1 h of reperfusion. During the first 15 min of reperfusion, hearts were treated with either
control buffer (CTRL group) or buffer containing 20 μmol/L atractyloside (ATR group), 3% (v/v) sevoflurane (SPC group), 50
μmol/L propofol (PPC group), or the combination of atractyloside with respective anesthetics (SPC+ATR and PPC+ATR groups).
Infarct size was determined by dividing the total necrotic area of the left ventricle by the total left ventricular slice
area (percent necrotic area). Results: Hearts treated with sevoflurane or propofol showed significantly better recovery of
coronary flow, end-diastolic pressures, left ventricular developed pressure and derivatives compared with controls. Sevoflurane
resulted in more protective alteration of hemodynamics at most time point of reperfusion than propofol. These improvements
were paralleled with the reduction of lactate dehydrogenase release and the decrease of infarct size (SPC vs CTRL: (17.48±2.70)%
vs (48.47±6.03)%, P<0.05; PPC vs CTRL: (35.60±2.10)% vs (48.47±6.03)%, P<0.05). SPC group had less infarct size than PPC group (SPC vs PPC: (17.48±2.70)% vs (35.60±2.10)%, P<0.05). Atractyloside coadministration attenuated or completely blocked the cardioprotective effect of postconditioning of
sevoflurane and propofol. Conclusion: Postconditioning of sevoflurane and propofol has cardioprotective effect against ischemia-reperfusion
injury of heart, which is associated with inhibition of MPTP opening. Compared to propofol, sevoflurane provides superior
protection of functional recovery and infarct size.
Project supported by the National Natural Science Foundation of China (No. 30772090), the Natural Science Foundation of Zhejiang
Province (No. Y204141), the Foundation from Science and Technology Department of Zhejiang Province (No. 2007R10034), the Foundation
from Personnel Department of Zhejiang Province (No. J20050046) and the Foundation from Health Department of Zhejiang Province
(No. 2007QN007), China |
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| Keywords: | Sevoflurane Propofol Postconditioning Reperfusion injury Mitochondrial permeability transition pore (MPTP) |
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