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Article: Synergy of isoflurane preconditioning and propofol postconditioning reduces myocardial reperfusion injury in patients
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TitleSynergy of isoflurane preconditioning and propofol postconditioning reduces myocardial reperfusion injury in patients
 
AuthorsHuang, Z5 2 1
Zhong, X4
Irwin, MG2
Ji, S5
Wong, GTC2
Liu, Y2
Xia, ZY1
Finegan, BA3
Xia, Z2 1
 
Issue Date2011
 
PublisherPortland Press Ltd. The Journal's web site is located at http://www.clinsci.org/
 
CitationClinical Science, 2011, v. 121 n. 2, p. 57-69 [How to Cite?]
DOI: http://dx.doi.org/10.1042/CS20100435
 
AbstractEither isoflurane preconditioning or high-dose propofol treatment has been shown to attenuate myocardial IRI (ischaemia/reperfusion injury) in patients undergoing CABG (coronary artery bypass graft) surgery. It is unknown whether isoflurane and propofol may synergistically attenuate myocardial injury in patients. The present study investigated the efficacy of IsoPC (isoflurane preconditioning), propofol treatment (postconditioning) and their synergy in attenuating postischaemic myocardial injury in patients undergoing CABG surgery using CPB (cardiopulmonary bypass). Patients (n = 120) selected for CABG surgery were randomly assigned to one of four groups (n = 30 each). After induction, anaesthesia was maintained either with fentanyl and midazolam (control; group C); with propofol at 100 mug x kg(-1) of body weight x min(-1) before and during CPB followed by propofol at 60 mug x kg(-1) of body weight x min(-1) for 15 min after aortic declamping (group P); with isoflurane 1-1.5% end tidal throughout the surgery (group I) or with isoflurane 1-1.5% end tidal before CPB and switching to propofol at 100 mug x kg(-1) of body weight x min(-1) during CPB followed by propofol at 60 mug x kg(-1) of body weight x min(-1) for 15 min after aortic declamping (group IP, i.e. IsoPC plus propofol postconditioning). A joint isoflurane and propofol anaesthesia regimen synergistically reduced plasma levels of cTnI (cardiac troponin I) and CK-MB (creatine kinase MB) and f-FABP (heart-type fatty acid-binding protein) (all P < 0.05 compared with control, group P or group I) and facilitated postoperative myocardial functional recovery. During reperfusion, myocardial tissue eNOS (endothelial NO synthase) protein expression in group IP was significantly higher, whereas nitrotyrosine protein expression was lower than those in the control group. In conclusion, a joint isoflurane preconditioning and propofol anaesthesia regimen synergistically attenuated myocardial reperfusion injury in patients.
 
ISSN0143-5221
2013 Impact Factor: 5.629
 
DOIhttp://dx.doi.org/10.1042/CS20100435
 
ISI Accession Number IDWOS:000293155200006
Funding AgencyGrant Number
National Natural Science Foundation of China (NSFC)30872447
30672033
Society of Cardiovascular Anesthesiologists (SCA) Foundation
Funding Information:

This study is supported, in part, by the National Natural Science Foundation of China (NSFC) [grant number 30872447, 30672033] and by a Society of Cardiovascular Anesthesiologists (SCA) Foundation Starter grant (to Z.X.).

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorHuang, Z
 
dc.contributor.authorZhong, X
 
dc.contributor.authorIrwin, MG
 
dc.contributor.authorJi, S
 
dc.contributor.authorWong, GTC
 
dc.contributor.authorLiu, Y
 
dc.contributor.authorXia, ZY
 
dc.contributor.authorFinegan, BA
 
dc.contributor.authorXia, Z
 
dc.date.accessioned2011-09-23T05:42:16Z
 
dc.date.available2011-09-23T05:42:16Z
 
dc.date.issued2011
 
dc.description.abstractEither isoflurane preconditioning or high-dose propofol treatment has been shown to attenuate myocardial IRI (ischaemia/reperfusion injury) in patients undergoing CABG (coronary artery bypass graft) surgery. It is unknown whether isoflurane and propofol may synergistically attenuate myocardial injury in patients. The present study investigated the efficacy of IsoPC (isoflurane preconditioning), propofol treatment (postconditioning) and their synergy in attenuating postischaemic myocardial injury in patients undergoing CABG surgery using CPB (cardiopulmonary bypass). Patients (n = 120) selected for CABG surgery were randomly assigned to one of four groups (n = 30 each). After induction, anaesthesia was maintained either with fentanyl and midazolam (control; group C); with propofol at 100 mug x kg(-1) of body weight x min(-1) before and during CPB followed by propofol at 60 mug x kg(-1) of body weight x min(-1) for 15 min after aortic declamping (group P); with isoflurane 1-1.5% end tidal throughout the surgery (group I) or with isoflurane 1-1.5% end tidal before CPB and switching to propofol at 100 mug x kg(-1) of body weight x min(-1) during CPB followed by propofol at 60 mug x kg(-1) of body weight x min(-1) for 15 min after aortic declamping (group IP, i.e. IsoPC plus propofol postconditioning). A joint isoflurane and propofol anaesthesia regimen synergistically reduced plasma levels of cTnI (cardiac troponin I) and CK-MB (creatine kinase MB) and f-FABP (heart-type fatty acid-binding protein) (all P < 0.05 compared with control, group P or group I) and facilitated postoperative myocardial functional recovery. During reperfusion, myocardial tissue eNOS (endothelial NO synthase) protein expression in group IP was significantly higher, whereas nitrotyrosine protein expression was lower than those in the control group. In conclusion, a joint isoflurane preconditioning and propofol anaesthesia regimen synergistically attenuated myocardial reperfusion injury in patients.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationClinical Science, 2011, v. 121 n. 2, p. 57-69 [How to Cite?]
DOI: http://dx.doi.org/10.1042/CS20100435
 
dc.identifier.doihttp://dx.doi.org/10.1042/CS20100435
 
dc.identifier.eissn1470-8736
 
dc.identifier.epage69
 
dc.identifier.hkuros193448
 
dc.identifier.isiWOS:000293155200006
Funding AgencyGrant Number
National Natural Science Foundation of China (NSFC)30872447
30672033
Society of Cardiovascular Anesthesiologists (SCA) Foundation
Funding Information:

This study is supported, in part, by the National Natural Science Foundation of China (NSFC) [grant number 30872447, 30672033] and by a Society of Cardiovascular Anesthesiologists (SCA) Foundation Starter grant (to Z.X.).

 
dc.identifier.issn0143-5221
2013 Impact Factor: 5.629
 
dc.identifier.issue2
 
dc.identifier.pmid21291422
 
dc.identifier.scopuseid_2-s2.0-79955583602
 
dc.identifier.spage57
 
dc.identifier.urihttp://hdl.handle.net/10722/138930
 
dc.identifier.volume121
 
dc.languageeng
 
dc.publisherPortland Press Ltd. The Journal's web site is located at http://www.clinsci.org/
 
dc.publisher.placeUnited Kingdom
 
dc.relation.ispartofClinical Science
 
dc.relation.referencesReferences in Scopus
 
dc.rightsThe final version of record is available at [http://www.clinsci.org/cs/default.htm].
 
dc.subject.meshIschemic Postconditioning - methods
 
dc.subject.meshIschemic Preconditioning, Myocardial - methods
 
dc.subject.meshIsoflurane - therapeutic use
 
dc.subject.meshMyocardial Reperfusion Injury - prevention and control
 
dc.subject.meshPropofol - therapeutic use
 
dc.titleSynergy of isoflurane preconditioning and propofol postconditioning reduces myocardial reperfusion injury in patients
 
dc.typeArticle
 
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<contributor.author>Wong, GTC</contributor.author>
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<contributor.author>Xia, ZY</contributor.author>
<contributor.author>Finegan, BA</contributor.author>
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Author Affiliations
  1. Hubei General Hospital
  2. The University of Hong Kong
  3. University of Alberta
  4. Zhongshan Ophthalmic Center
  5. Sun Yat-sen Cardiovascular Hospital