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Med Gas Res. 2016 Oct 14;6(3):130-137. doi: 10.4103/2045-9912.191358. eCollection 2016.

Xenon protects left ventricular diastolic function during acute ischemia, less than ischemic preconditioning.

Medical gas research

Jan-H Baumert, Anna B Roehl, Sandra Funcke, Marc Hein

Affiliations

  1. Department of Anesthesiology, Intensive Care and Pain Medicine, KRH Klinikum Nordstadt, Hannover, Germany.
  2. Department of Anesthesiology, University Hospital Aachen, Aachen, Germany.

PMID: 27867480 PMCID: PMC5110144 DOI: 10.4103/2045-9912.191358

Abstract

Anesthetics modify regional left ventricular (LV) dysfunction following ischemia/reperfusion but their effects on global function in this setting are less clear. Aim of this study was to test the hypothesis that xenon would limit global LV dysfunction as caused by acute anterior wall ischemia, comparable to ischemic preconditioning. In an open-chest model under thiopental anesthesia, 30 pigs underwent 60-minute left anterior descending coronary artery occlusion, followed by 120 minutes of reperfusion. A xenon group (constant inhalation from previous to ischemia through end of reperfusion) was compared to control and ischemic preconditioning. Load-independent measures of diastolic function (end-diastolic pressure-volume relation, time constant of relaxation) and systolic function (end-systolic pressure-volume relation, preload-recruitable stroke work) were determined. Heart rate, arterial pressure, cardiac output, and arterial elastance were recorded. Data were compared in 26 pigs. Ischemia impaired global diastolic but not systolic function in control, which recovered during reperfusion. Xenon limited and preconditioning abolished diastolic dysfunction during ischemia. Arterial pressure decreased during reperfusion while arterial elastance increased. Tachycardia and antero-septal wall edema during reperfusion were observed in all groups. In spite of ischemia of 40% of LV mass, global systolic function was preserved. Deterioration in global diastolic function was limited by xenon and prevented by preconditioning.

Keywords: conductance technique; inhalation anesthesia; ischemic preconditioning; myocardial ischemia; myocardial protection; myocardial reperfusion; xenon

Conflict of interest statement

The authors declare no conflicts of interest.

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