title: Myocardial Perfusion and Function Are Distinctly Altered by Sevoflurane Anesthesia in Diet-Induced Prediabetic Rats.
abstract: Preservation of myocardial perfusion during surgery is particularly important in patients with increased risk for perioperative complications, such as diabetes. Volatile anesthetics, like sevoflurane, have cardiodepressive effects and may aggravate cardiovascular complications. We investigated the effect of sevoflurane on myocardial perfusion and function in prediabetic rats. Rats were fed a western diet (WD; n = 18) or control diet (CD; n = 18) for 8 weeks and underwent (contrast) echocardiography to determine perfusion and function during baseline and sevoflurane exposure. Myocardial perfusion was estimated based on the product of microvascular filling velocity and blood volume. WD-feeding resulted in a prediabetic phenotype characterized by obesity, hyperinsulinemia, hyperlipidemia, glucose intolerance, and hyperglycemia. At baseline, WD-feeding impaired myocardial perfusion and systolic function compared to CD-feeding. Exposure of healthy rats to sevoflurane increased the microvascular filling velocity without altering myocardial perfusion but impaired systolic function. In prediabetic rats, sevoflurane did also not affect myocardial perfusion; however, it further impaired systolic function. Diet-induced prediabetes is associated with impaired myocardial perfusion and function in rats. While sevoflurane further impaired systolic function, it did not affect myocardial perfusion in prediabetic rats. Our findings suggest that sevoflurane anesthesia leads to uncoupling of myocardial perfusion and function, irrespective of the metabolic state.
authors.affiliation: Department of Anesthesiology, VU University Medical Center, Boelelaan 1117, 1081 HV Amsterdam, Netherlands; Laboratory for Physiology, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands.
authors.forename: Charissa E
authors.initials: CE
authors.lastname: van den Brom
authors.affiliation: Department of Anesthesiology, VU University Medical Center, Boelelaan 1117, 1081 HV Amsterdam, Netherlands; Laboratory for Physiology, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands.
authors.forename: Chantal A
authors.initials: CA
authors.lastname: Boly
authors.affiliation: Department of Anesthesiology, VU University Medical Center, Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Carolien S E
authors.initials: CS
authors.lastname: Bulte
authors.affiliation: Department of Anesthesiology, VU University Medical Center, Boelelaan 1117, 1081 HV Amsterdam, Netherlands; Laboratory for Physiology, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands.
authors.forename: Rob F P
authors.initials: RF
authors.lastname: van den Akker
authors.affiliation: Laboratory for Physiology, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands.
authors.forename: Rick F J
authors.initials: RF
authors.lastname: Kwekkeboom
authors.affiliation: Department of Anesthesiology, VU University Medical Center, Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Loer
authors.affiliation: Department of Anesthesiology, VU University Medical Center, Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Christa
authors.initials: C
authors.lastname: Boer
authors.affiliation: Department of Anesthesiology, VU University Medical Center, Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: R Arthur
authors.initials: RA
authors.lastname: Bouwman
mesh_terms: D018685:Anesthetics, Inhalation / Q000633:toxicity*; D000818:Animals; D003326:Coronary Circulation / Q000187:drug effects*; D066273:Diet, Western; D004195:Disease Models, Animal; D004452:Echocardiography; D008297:Male; D008738:Methyl Ethers / Q000633:toxicity*; D008833:Microcirculation / Q000187:drug effects*; D055414:Myocardial Perfusion Imaging / Q000379:methods; D010641:Phenotype; D011236:Prediabetic State / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D017208:Rats, Wistar; D000077149:Sevoflurane; D013599:Systole; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane
references.citation: Cardiovasc Diabetol. 2010;9:25
references.pmid: 20550678
references.citation: Anesth Analg. 1992 Jan;74(1):79-88
references.pmid: 1734802
references.citation: Anesth Analg. 1992 Dec;75(6):1000-6
references.pmid: 1443679
references.citation: Cardiovasc Diabetol. 2012;11:74
references.pmid: 22716959
references.citation: Herz. 1999 Nov;24(7):509-14
references.pmid: 10609156
references.citation: PLoS Biol. 2010;8(6):e1000412
references.pmid: 20613859
references.citation: J Pharmacol Exp Ther. 1984 Dec;231(3):640-8
references.pmid: 6502517
references.citation: Anesthesiology. 1991 Aug;75(2):268-78
references.pmid: 1859014
references.citation: Anesth Analg. 2012 May;114(5):938-45
references.pmid: 22366851
references.citation: Int J Cardiovasc Imaging. 2011 Mar;27(3):335-41
references.pmid: 20730497
references.citation: Circulation. 1999 Sep 7;100(10):1043-9
references.pmid: 10477528
references.citation: Heart Vessels. 2013 Nov;28(6):757-68
references.pmid: 23180239
references.citation: Anesthesiology. 1995 Nov;83(5):918-28
references.pmid: 7486177
references.citation: J Am Soc Echocardiogr. 2006 Dec;19(12):1520-5
references.pmid: 17138038
references.citation: Circulation. 2009 Jul 21;120(3):212-20
references.pmid: 19581493
references.citation: Cardiovasc Diabetol. 2014;13:62
references.pmid: 24656118
references.citation: Diabetologia. 2007 Sep;50(9):1938-48
references.pmid: 17639306
references.citation: Circulation. 2005 Jul 12;112(2):179-84
references.pmid: 15998667
references.citation: Anesthesiology. 2000 Apr;92(4):1103-13
references.pmid: 10754631
references.citation: Physiol Rev. 1990 Apr;70(2):331-90
references.pmid: 2181499
references.citation: Prog Cardiovasc Dis. 1987 Jan-Feb;29(4):293-323
references.pmid: 3809516
references.citation: Cardiovasc Diabetol. 2009;8:39
references.pmid: 19624828
references.citation: Diabetes Care. 2006 Jan;29(1):95-100
references.pmid: 16373903
references.citation: Basic Res Cardiol. 2007 Jan;102(1):28-41
references.pmid: 17006633
references.citation: Int Anesthesiol Clin. 2002 Winter;40(1):1-14
references.pmid: 11910245
references.citation: Anesth Analg. 1995 Apr;80(4):651-6
references.pmid: 7893013
references.citation: Anesth Analg. 2013 Apr;116(4):767-74
references.pmid: 23385053
references.citation: J Cardiovasc Dis Res. 2010 Jul;1(3):116-21
references.pmid: 21187864