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Clinical and Experimental Circulation

Ischemic preconditioning, but not sevoflurane, reduces myocardial infarct size in a porcine closed-chest ischemia-reperfusion model


Rolighed Larsen, J.1; Sloth, E.1; Aagaard, S.2; Hasenkam, J. M.3

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European Journal of Anaesthesiology (EJA): June 2006 - Volume 23 - Issue - p 65
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Background and Goal of Study: The endogenous cellular protection mechanism preconditioning, has chiefly been investigated in animals with collateral coronary flow. Preconditioning with either ischemia or sevoflurane was examined in a porcine experimental model featuring no or little collateral coronary flow.

Materials and Methods: Randomized, controlled, animal experimental trial. N = 25 20 kg pigs were subjected to 40 min ischemia of the distal LAD-region under pentobarbital anesthesia, followed by 2.5 hr reperfusion, risk area (aar)-staining, euthanasia and infarct-staining (is) by the tetrazolium method. Prior to ischemia pigs were randomized to 2 × 5 min pre-ischemia (n = 8), or 2 × 5 min 4% vol inhaled sevoflurane (n = 10), and n = 7 pigs acted as controls IS/AAR was compared between groups. Ventricular contractile performance was monitored using tissue Doppler echocardiography (peak systolic velocity) in the basal interventricular septum.

Results and Discussions: Preliminary results (n = 25) are depicted. IS/AAR is reduced by 50% by ischemia, but unchanged by sevoflurane. The porcine coronary anatomy may account for this, and because of its similarity to human coronary anatomy be implicated in negligible clinical results from sevoflurane preconditioning upon necrosis.

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Conclusion(s): Histopathological and ventricular functional changes were observed following pharmacological intervention with inhaled sevoflurane in an in vivo experimental porcine ischemia-reperfusion model. The changes were smaller than expected, possibly explained by no coronary collaterals in this model.

© 2006 European Society of Anaesthesiology