Sevoflurane preconditions stunned myocardium in septic but not healthy isolated rat hearts.
BACKGROUND
Recent evidence indicates that sevoflurane treatment before prolonged ischaemia reduces infarct size in normal hearts, mimicking ischaemic preconditioning. We examined whether exposure to sevoflurane before brief ischaemia, inducing a 'stunned myocardium', provided such protective effects in an isolated working heart from normal or septic rats.


METHODS
With institutional approval, 91 rats were randomly allocated into one of either caecal-ligation and perforation (CLP: n=50) or sham (Sham: n=41) procedure groups 24 h before the study. After determination of baseline measurements, including cardiac output (CO), myocardial oxygen consumption (mVO(2)) and cardiac efficiency (CE; CO x peak systolic pressure/mVO(2)), each isolated heart was perfused with or without 2% sevoflurane for 15 min before global ischaemia (pre-ischaemia). After 15 min ischaemia and 30 min reperfusion, all hearts were assessed for functional recovery of myocardium (post-reperfusion).


RESULTS
During the pre-ischaemia period, 2% sevoflurane caused a significant reduction of CO in the CLP group compared with the Sham group. During the post-reperfusion period, both CO (16.9 vs 11.0 ml min(-1)) and CE (11.2 vs 7.7 mm Hg ml(-1) ( micro l O(2))(-1)) was higher in the sevoflurane-treated vs -untreated hearts from CLP rats, and was accompanied by lower incidence of reperfusion arrhythmia compared with control hearts (8 vs 32%). In contrast, 2% sevoflurane did not provide cardioprotective effects in normal rats.


CONCLUSIONS
The current study demonstrates that pre-treatment with sevoflurane minimizes myocardial dysfunction and the incidence of reperfusion arrhythmia after brief ischaemic insults in septic hearts.
Serita
R
R
Department of Anaesthesiology and General Intensive Care Unit, Keio University School of Medicine, Tokyo 160-8582, Japan. anesmrsk@sc.itc.keio.ac.jp
Morisaki
H
H
Ai
K
K
Morita
Y
Y
Innami
Y
Y
Satoh
T
T
Kosugi
S
S
Kotake
Y
Y
Takeda
J
J
D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology; D002302:Cardiac Output; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D019157:Ischemic Preconditioning, Myocardial; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology; D017682:Myocardial Stunning / Q000503:physiopathology*; D010101:Oxygen Consumption; D010710:Phosphates / Q000032:analysis; D051381:Rats; D017208:Rats, Wistar; D018805:Sepsis / Q000503:physiopathology*; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D010710:Phosphates; D000077149:Sevoflurane