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Infusion of the ß-adrenergic blocker esmolol attenuates myocardial dysfunction in septic rats*

Suzuki, Takeshi MD; Morisaki, Hiroshi MD; Serita, Ryohei MD; Yamamoto, Michiko BA; Kotake, Yoshifumi MD; Ishizaka, Akitoshi MD; Takeda, Junzo MD

doi: 10.1097/01.CCM.0000182796.11329.3B
Laboratory Investigations

Objective: Since β-blocker therapy is known to be effective in patients with an injured heart, such as infarction, we designed the present study to examine the protective effects of infusion of the β1-selective blocker esmolol on myocardial function in peritonitis-induced septic rats using an isolated working heart preparation.

Design: Randomized animal study.

Setting: University research laboratory.

Subjects: Thirty-one rats treated with cecal ligation and perforation to evoke peritonitis.

Interventions: After cecal ligation and perforation, rats were randomly allocated to the control group (normal saline 2 mL/hr, n = 11), low-dose esmolol group (10 mg/kg/hr, n = 10), or high-dose esmolol group (20 mg/kg/hr, n = 10). After obtaining blood samples for measurement of arterial lactate and tumor necrosis factor-α at 24 hrs, we assessed cardiac output, myocardial oxygen consumption, and cardiac efficiency (cardiac output × peak systolic pressure/myocardial oxygen consumption) at various preloads in an isolated perfused heart preparation.

Measurements and Main Results: Esmolol infusion did not cause an elevation of arterial lactate levels but reduced tumor necrosis factor-α concentrations vs. the control group (p < .05). Both cardiac output and cardiac efficiency in the esmolol-treated rats were significantly higher throughout the study periods vs. the control group (p < .05).

Conclusions: Esmolol infusion in sepsis improved oxygen utilization of myocardium and preserved myocardial function.

From the Department of Anesthesiology (TS, HM, RS, MY, YK, JT) and Department of Medicine (AI), Keio University School of Medicine, Tokyo, Japan.

Supported by departmental sources.

None of the authors has a commercial association or financial involvement that might pose a conflict of interest in connection with this article.

Address requests for reprints to: Hiroshi Morisaki, MD, Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. E-mail: anesmrsk@sc.itc.keio.ac.jp.

© 2005 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins