Key result
Peri-ischemic propofol reduces myocardial infarct size by an absolute ~21 percentage points in rats.
Why the study?
Propofol is known to protect the myocardium against global ischemia-reperfusion injury in isolated rat hearts. Whether clinically relevant concentrations of propofol infused during the peri-ischemic period also protect against regional myocardial ischemia-reperfusion injury in vivo remained to be investigated.
Does clinically relevant peri-ischemic propofol infusion reduce myocardial infarct size and improve hemodynamic function after regional myocardial ischemia-reperfusion injury in an in vivo rat heart model?
Does clinically relevant peri-ischemic propofol infusion reduce myocardial infarct size and improve hemodynamic function after regional myocardial ischemia-reperfusion injury in an in vivo rat heart model?
Clinically relevant concentrations of propofol infused during the peri-ischemic period preserve left ventricular systolic and diastolic function and reduce myocardial infarct size at 24 hours in an in vivo rat model of regional ischemia-reperfusion injury.
Answers are grounded in this paper and cite their sources.
Does not support peri-ischemic propofol in patients; hypothesis-generating for cardioprotection in ischemia-reperfusion.
Background: It is known that propofol protects myocardium against a global ischemia-reperfusion injury in the isolated rat heart model.The aim of this study was to investigate whether propofol, at a clinically relevant concentration infused during the peri-ischemic period, also provides a protective effect against a regional myocardial ischemia-reperfusion injury in vivo.Methods: Rats were subjected to 25 minutes of coronary artery occlusion followed by 24 hours of reperfusion.Propofol or intralipid was administrated during 35 minutes starting 5 minutes before the onset of ischemia until 5 minutes after the onset of reperfusion.A micromanometer catheter was advanced into the left ventricle and the hemodynamic function was evaluated.The infarct size was determined by triphenyltetrazolium staining after 24 hours of reperfusion.Results: Propofol administration during the peri-ischemic period demonstrated protective effects on hemodynamic function and infarct size reduction.In the control group, the peak rate of the ventricular pressure increase (+dP/dtmax)(P = 0.0001) and the peak rate of the intraventricular pressure decline (-dP/dtmax)(P = 0.0001) were significantly decreased compared to the sham group.In the propofol group, the +dP/dtmax (P = 0.003) and -dP/dtmax (P = 0.002) were significantly improved compared to the control group.The infarct size was 47.6% of the area at risks in the control group, and was reduced markedly by administration of propofol during the peri-ischemic period to 26.2% in the propofol group (P = 0.004).Conclusions: Propofol, at a clinically relevant concentration infused during the peri-ischemic period, have protective effect after regional myocardial ischemia-reperfusion injury in an in vivo rat heart model.(Korean J Anesthesiol 2008; 55: 338∼43)
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Shin et al. (2008) studied Regional myocardial ischemia-reperfusion injury (in vivo rat heart model) (n=40). Propofol vs. Control group (0.9% normal saline) and Intralipid group (20% intralipid diluted in normal saline) was evaluated on Infarct area weight as a percentage of the area at risk at 24 hours of reperfusion (p=0.004). Propofol infusion during the peri-ischemic period reduced myocardial infarct size from 47.6% to 26.2% of the area at risk compared to control in an in vivo rat model (P = 0.004).
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