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Anesthetic Agents Isoflurane and Propofol Decrease Maximal Ca2+-Activated Force and Thus Contractility in the Failing Myocardium

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单位: [1]Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China [2]Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China [3]Department of Cardiac Surgery, Tongji University Medical Center, Wuhan, China [4]Division of Cardiology,Johns Hopkins University School of Medicine, Baltimore, Maryland, USA [5]Department of Anesthesiology and Critical Care Medicine,Johns Hopkins University School of Medicine, Baltimore, Maryland, USA [6]Department of Biomedical Sciences, University of Padova, Padova, Italy
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In the normal heart, frequently used anesthetics such as isoflurane and propofol can reduce inotropy. However, the impact of these agents on the failing myocardium is unclear. Here, we examined whether and how isoflurane and propofol influence cardiac contractility in intact cardiac muscles from rats treated with monocrotaline to induce heart failure. We measured force and intracellular Ca2+ ([Ca2+](i)) in trabeculae from the right ventricles of the rats in the absence or presence of propofol or isoflurane. At low to moderate concentrations, both propofol and isoflurane dose-dependently depressed cardiac force generation in failing trabeculae without altering [Ca2+](i). At high doses, propofol (but not isoflurane) also decreased amplitude of [Ca2+](i) transients. During steady-state activation, both propofol and isoflurane impaired maximal Ca2+-activated force (F-max) while increasing the amount of [Ca2+](i) required for 50% of maximal activation (Ca-50). These events occurred without apparent change in the Hill coefficient, suggesting no impairment of cooperativity. Exposing these same muscles to the anesthetics after fiber skinning resulted in a similar decrement in F-max and rise in Ca-50 but no change in the myofibrillar ATPase-Ca2+ relationship. Thus, our study demonstrates that challenging the failing myocardium with commonly used anesthetic agents such as propofol and isoflurane leads to reduced force development as a result of lowered myofilament responsiveness to Ca2+. SIGNIFICANCE STATEMENT Commonly used anesthetics such as isoflurane and propofol can impair myocardial contractility in subjects with heart failure by lowering myofilament responsiveness to Ca2+. High doses of propofol can also reduce the overall amplitude of the intracellular Ca2+ transient. These findings may have important implications for the safety and quality of intra- and perioperative care of patients with heart failure and other cardiac disorders.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 2 区 药学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 药学
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出版当年[2017]版:
Q1 PHARMACOLOGY & PHARMACY
最新[2023]版:
Q2 PHARMACOLOGY & PHARMACY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2017版] 出版当年五年平均[2013-2017] 出版前一年[2016版] 出版后一年[2018版]

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第一作者单位: [1]Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shangdong, China
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通讯机构: [5]Department of Anesthesiology and Critical Care Medicine,Johns Hopkins University School of Medicine, Baltimore, Maryland, USA [*1]Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Zayed 6208, 1800 Orleans Street, Baltimore, MD 21287.
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