Effects of Glucose Concentration on Propofol Cardioprotection against Myocardial Ischemia Reperfusion Injury in Isolated Rat Hearts.
The anesthetic propofol confers cardioprotection against myocardial ischemia-reperfusion injury (IRI) by reducing reactive oxygen species (ROS). However, its cardioprotection on patients is inconsistent. Similarly, the beneficial effect of tight glycemic control during cardiac surgery in patients has recently been questioned. We postulated that low glucose (LG) may promote ROS formation through enhancing fatty acid (FA) oxidation and unmask propofol cardioprotection during IRI. Rat hearts were isolated and randomly assigned to be perfused with Krebs-Henseleit solution with glucose at 5.5 mM (LG) or 8 mM (G) in the absence or presence of propofol (5 μg/mL) or propofol plus trimetazidine (TMZ). Hearts were subjected to 35 minutes of ischemia followed by 60 minutes of reperfusion. Myocardial infarct size (IS) and cardiac CK-MB were significantly higher in LG than in G group (P < 0.05), associated with reduced left ventricular developed pressure and increases in postischemic cardiac contracture. Cardiac 15-F2t-isoprostane was higher, accompanied with higher cardiac lipid transporter CD36 protein expression in LG. Propofol reduced IS, improved cardiac function, and reduced CD36 in G but not in LG. TMZ facilitated propofol cardioprotection in LG. Therefore, isolated heart with low glucose lost sensitivity to propofol treatment through enhancing FA oxidation and TMZ supplementation restored the sensitivity to propofol.
Department of Anesthesiology, Guangzhou Hospital of Traditional Chinese Medicine, Guangzhou 510130, China.
Xinhua
X
Yao
Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Yalan
Y
Li
Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Mingzhe
M
Tao
Department of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China.
Shuang
S
Wang
Department of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China.
Liangqing
L
Zhang
Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
Jiefu
J
Lin
Department of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, Guangdong 524001, China ; Department of Anesthesiology, The University of Hong Kong, Hong Kong.
Zhengyuan
Z
Xia
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Hui-Min
HM
Liu
D000818:Animals; D004305:Dose-Response Relationship, Drug; D005947:Glucose / Q000008:administration & dosage*; D006321:Heart / Q000187:drug effects*; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects; D017202:Myocardial Ischemia / Q000378:metabolism; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism*; D015742:Propofol / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D017382:Reactive Oxygen Species / Q000378:metabolism
D017382:Reactive Oxygen Species; D005947:Glucose; D015742:Propofol