Journal of Cardiothoracic and Vascular Anesthesia
Volume 22, Issue 3 , Pages 369-376 , June 2008

Myocardial Metabolism Altered by Ischemic Preconditioning and Enflurane in Off-Pump Coronary Artery Surgery

  • Benjamin Drenger, MD

      Affiliations

    • Department of Anesthesiology and Critical Care Medicine, Hadassah–Hebrew University Medical Center Hospital and the Hebrew University School of Medicine, Jerusalem, Israel
    • Corresponding Author InformationAddress reprint requests to Benjamin Drenger, MD, Department of Anesthesiology and Critical Care Medicine, Hadassah University Hospital, PO Box 24035, Jerusalem 91240, Israel.
    • ,
  • Dan Gilon, MD

      Affiliations

    • Department of Cardiology, Hadassah–Hebrew University Medical Center Hospital and the Hebrew University School of Medicine, Jerusalem, Israel
    • ,
  • Mordechai Chevion, PhD

      Affiliations

    • Department of Cellular Biochemistry, Hadassah–Hebrew University Medical Center Hospital and the Hebrew University School of Medicine, Jerusalem, Israel
    • ,
  • Amir Elami, MD

      Affiliations

    • Department of Cardiac Surgery, Hadassah–Hebrew University Medical Center Hospital and the Hebrew University School of Medicine, Jerusalem, Israel.
    • ,
  • Yuval Meroz, MD

      Affiliations

    • Department of Anesthesiology and Critical Care Medicine, Hadassah–Hebrew University Medical Center Hospital and the Hebrew University School of Medicine, Jerusalem, Israel
    • ,
  • Eli Milgalter, MD

      Affiliations

    • Department of Cardiac Surgery, Hadassah–Hebrew University Medical Center Hospital and the Hebrew University School of Medicine, Jerusalem, Israel.
    • ,
  • Yaacov Gozal, MD

      Affiliations

    • Department of Anesthesiology and Critical Care Medicine, Hadassah–Hebrew University Medical Center Hospital and the Hebrew University School of Medicine, Jerusalem, Israel

References 

  1. Chassot PG, van der Linden P, Zaugg M, et al. Off-pump coronary artery bypass surgery: Physiology and anaesthetic management. Br J Anaesth. 2004;92:400–413
  2. Laurikka J, Wu ZK, Iisalo P, et al. Regional ischemic preconditioning enhances myocardial performance in off-pump coronary artery bypass grafting. Chest. 2002;121:1183–1189
  3. Wu ZK, Iivainen T, Pehkonen E, et al. Arrhythmias in off-pump coronary artery bypass grafting and the antiarrhythmic effect of regional ischemic preconditioning. J Cardiothorac Vasc Anesth. 2003;17:459–464
  4. Conzen PF, Fischer S, Detter C, et al. Sevoflurane provides greater protection of the myocardium than propofol in patients undergoing off-pump coronary artery bypass surgery. Anesthesiology. 2003;99:826–833
  5. Bein B, Renner J, Caliebe D, et al. Sevoflurane but not propofol preserves myocardial function during minimally invasive direct coronary artery bypass surgery. Anesth Analg. 2005;100:610–616
  6. Jenkins DP, Pugsley WB, Alkhulaifi AM, et al. Ischaemic preconditioning reduces troponin T release in patients undergoing coronary artery bypass surgery. Heart. 1997;77:314–318
  7. Perrault LP, Menasche P, Bel A, et al. Ischemic preconditioning in cardiac surgery: A word of caution. J Thorac Cardiovasc Surg. 1996;112:1378–1386
  8. Malkowski MJ, Kramer CM, Parvizi ST, et al. Transient ischemia does not limit subsequent ischemic regional dysfunction in humans: A transesophageal echocardiographic study during minimally invasive coronary artery bypass surgery. J Am Coll Cardiol. 1998;31:1035–1039
  9. Guarracino F, Landoni G, Tritapepe L, et al. Myocardial damage prevented by volatile anesthetics: A multicenter randomized controlled study. J Cardiothorac Vasc Anesth. 2006;20:477–483
  10. Law-Koune JD, Raynaud C, Liu N, et al. Sevoflurane-remifentanil versus propofol-remifentanil anesthesia at a similar bispectral level for off-pump coronary artery surgery: No evidence of reduced myocardial ischemia. J Cardiothorac Vasc Anesth. 2006;20:484–492
  11. Penta de Peppo A, Polisca P, Tomai F, et al. Recovery of LV contractility in man is enhanced by preischemic administration of enflurane. Ann Thorac Surg. 1999;68:112–118
  12. Powell SR, Hall D. Use of salicylate as a probe for ·OH formation in isolated ischemic rat hearts. Free Rad Biol Med. 1990;9:133–141
  13. Glantz L, Ginosar Y, Chevion M, et al. Halothane prevents postischemic production of hydroxyl radicals in the canine heart. Anesthesiology. 1997;86:440–447
  14. In:  Goldstein H editors. Multilevel statistical models, in Kendall's Library of Statistics 3. ed 2. London: Edward Arnold; 1995;
  15. Collard CD, Gelman S. Pathophysiology, clinical manifestations, and prevention of ischemia-reperfusion injury. Anesthesiology. 2001;94:1133–1138
  16. Kersten JR, Schmeling TJ, Hettrick DA, et al. Mechanism of myocardial protection by isoflurane: Role of adenosine triphosphate-regulated potassium (KATP) channels. Anesthesiology. 1996;85:794–807
  17. Liu Y, Sato T, O'Rourke B, et al. Mitochondrial ATP-dependent potassium channels: Novel effectors of cardioprotection?. Circulation. 1998;97:2463–2469
  18. Gozal Y, Chevion M, Elami A, et al. Ischaemic preconditioning but not isoflurane prevents postischaemic production of hydroxyl radicals in a canine model of ischaemia-reperfusion. Eur J Anaesthesiol. 2005;22:49–55
  19. Mullenheim J, Ebel D, Bauer M, et al. Sevoflurane confers additional cardioprotection after ischemic late preconditioning in rabbits. Anesthesiology. 2003;99:624–631
  20. Warltier DC, Al-Wathiqui MH, Kampine JP, et al. Recovery of contractile function of stunned myocardium in chronically instrumented dogs is enhanced by halothane or isoflurane. Anesthesiology. 1988;69:552–565
  21. Drenger B, Ginosar Y, Gozal Y. Effect of halothane on sarcolemmal calcium channels during myocardial ischemia and reperfusion. Adv Pharmacol. 1994;31:89–97
  22. Bouwman RA. Volatile anesthetics and the heart: Mechanisms of sevoflurane-induced cardioprotection. [dissertation] In: Amsterdam: Vrije University; 2006;p. 11–35
  23. Belhomme D, Peynet J, Louzy M, et al. Evidence for preconditioning by isoflurane in coronary artery bypass graft surgery. Circulation. 1999;100(suppl 2):340–344
  24. De Hert SG, ten Broecke PW, Mertens E, et al. Sevoflurane but not propofol preserves myocardial function in coronary surgery patients. Anesthesiology. 2002;97:42–49
  25. Julier K, Da Silva R, Garcia C, et al. Preconditioning by sevoflurane decreases biochemical markers for myocardial and renal dysfunction in coronary artery bypass graft surgery: A double-blinded, placebo-controlled, multicenter study. Anesthesiology. 2003;98:1315–1327
  26. Wang X, Järvinen O, Kuukasjärvi P, et al. Isoflurane produces only minor preconditioning in coronary artery bypass grafting. Scand Cardiovasc J. 2004;38:287–292
  27. Penttila HJ, Lepojarvi MV, Kiviluoma KT, et al. Myocardial preservation during coronary surgery with and without cardiopulmonary bypass. Ann Thorac Surg. 2001;71:565–571
  28. Buxton DB, Mody FV, Krivokapich J, et al. Metabolism in nonischemic myocardium during coronary artery occlusion and reperfusion. J Mol Cell Cardiol. 1993;25:667–681
  29. Crystal GJ, Gurevicius J, Salem MR, et al. Role of adenosine triphosphate-sensitive potassium channels in coronary vasodilation by halothane, isoflurane, and enflurane. Anesthesiology. 1997;86:448–458
  30. De Hert S, Van der Linden PJ, Cromheecke SM, et al. Cardioprotective properties of sevoflurane in patients undergoing coronary surgery with cardiopulmonary bypass are related to the modalities of its administration. Anesthesiology. 2004;101:299–310
  31. Landoni G, Biondi-Zoccai GGL, Zangrillo A, et al. Desflurane and sevoflurane in cardiac surgery: A meta-analysis of randomized clinical trials. J Cardiothorac Vasc Anesth. 2007;21:502–511

 Supported in part by The Administrator General Fund, Ministry of Justice, and the Berman Fund for Heart Research.

PII: S1053-0770(07)00407-7

doi: 10.1053/j.jvca.2007.12.023

Journal of Cardiothoracic and Vascular Anesthesia
Volume 22, Issue 3 , Pages 369-376 , June 2008

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