心筋虚血再灌流障害に対するセボフルランによる抑制効果―投与方法による比較検討

心筋虚血再灌流ウサギモデルにおいて,心筋壊死縮小効果をもたらすセボフルランの投与方法を検討した。ケタミン/ザイラジン(K/X)で麻酔したコントロール群,さらに1.5%セボフルランを持続投与した群(K/X+1.5S群),2.1%セボフルランの持続投与群(2.1S群),1.5%セボフルランでプレコンディショニングを行った群(Pre群),ポストコンディショニングを行った群(Post群)に分類し,虚血再灌流を行った。心筋梗塞域/虚血域のサイズからコントロール群に比べ他の4群では虚血再灌流後の心筋壊死縮小効果が有意に大きかった。またPre群とPost群の虚血再灌流後の心筋壊死縮小効果は2.1S群に比べて...

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Published in蘇生 Vol. 33; no. 2; pp. 63 - 68
Main Authors 今泉, うの, 吉田, 和市, 有坂, 博史, 板倉, 紹子, 髙田, 一毅
Format Journal Article
LanguageJapanese
Published 日本蘇生学会 25.09.2014
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ISSN0288-4348
1884-748X
DOI10.11414/jjreanimatology.33.63

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Abstract 心筋虚血再灌流ウサギモデルにおいて,心筋壊死縮小効果をもたらすセボフルランの投与方法を検討した。ケタミン/ザイラジン(K/X)で麻酔したコントロール群,さらに1.5%セボフルランを持続投与した群(K/X+1.5S群),2.1%セボフルランの持続投与群(2.1S群),1.5%セボフルランでプレコンディショニングを行った群(Pre群),ポストコンディショニングを行った群(Post群)に分類し,虚血再灌流を行った。心筋梗塞域/虚血域のサイズからコントロール群に比べ他の4群では虚血再灌流後の心筋壊死縮小効果が有意に大きかった。またPre群とPost群の虚血再灌流後の心筋壊死縮小効果は2.1S群に比べて有意に大きかった。プレコンディショニング,ポストコンディショニングは心筋保護効果がほぼ同等の強さであることが示唆された。
AbstractList 「要旨」心筋虚血再灌流ウサギモデルにおいて, 心筋壊死縮小効果をもたらすセボフルランの投与方法を検討した. ケタミン/ザイラジン(K/X)で麻酔したコントロール群, さらに1.5%セボフルランを持続投与した群(K/X+1.5S群), 2.1%セボフルランの持続投与群(2.1S群), 1.5%セボフルランでプレコンディショニングを行った群(Pre群), ポストコンディショニングを行った群(Post群)に分類し, 虚血再灌流を行った. 心筋梗塞域/虚血域のサイズからコントロール群に比べ他の4群では虚血再灌流後の心筋壊死縮小効果が有意に大きかった. またPre群とPost群の虚血再灌流後の心筋壊死縮小効果は2.1S群に比べて有意に大きかった. プレコンディショニング, ポストコンディショニングは心筋保護効果がほぼ同等の強さであることが示唆された.
心筋虚血再灌流ウサギモデルにおいて,心筋壊死縮小効果をもたらすセボフルランの投与方法を検討した。ケタミン/ザイラジン(K/X)で麻酔したコントロール群,さらに1.5%セボフルランを持続投与した群(K/X+1.5S群),2.1%セボフルランの持続投与群(2.1S群),1.5%セボフルランでプレコンディショニングを行った群(Pre群),ポストコンディショニングを行った群(Post群)に分類し,虚血再灌流を行った。心筋梗塞域/虚血域のサイズからコントロール群に比べ他の4群では虚血再灌流後の心筋壊死縮小効果が有意に大きかった。またPre群とPost群の虚血再灌流後の心筋壊死縮小効果は2.1S群に比べて有意に大きかった。プレコンディショニング,ポストコンディショニングは心筋保護効果がほぼ同等の強さであることが示唆された。
Author 吉田, 和市
今泉, うの
髙田, 一毅
有坂, 博史
板倉, 紹子
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References 3) Han Y, Zhao H, Tang H, et al:20-hydroxyeicosatetraenoic Acid mediates isolated heart ischemia/reperfusion injury by increasing NADPH oxidase-derived reactive oxygen species production. Circ J 77(7):1807-1816, 2013
13) De Hert SG, Van der Linden PJ, Cromheecke S:Choice of primary anesthetic regimen can influence intensive care unit length of stay after coronary surgery with cardiopulmonary bypass. Anesthesiology 101(1):9-20, 2004
21) Maxwell MP, Hearse DJ, Yellon DM:Species variation in the coronary collateral circulation during regional myocardial ischaemia:a critical determinant of the rate of evolution and extent of myocardial infarction. Cardiovasc Res 21(10):737-746, 1987
4) Murry CE, Jenning RB, Reimer KA:Preconditioning with ischemia:a delay of lethal cell injury in ischemic myocardium. Circulation 74(5):1124-1136, 1986
10) Lamberts RR, Onderwater G, Hamdani N, et al:Reactive oxygen species-induced stimulation of 5'AMP-activated protein kinase mediates sevoflurane-induced cardioprotection. Circulation 120(11):S10-15, 2009
11) 丸山久雄,吉田和市,神田元彦,ほか:揮発性吸入麻酔薬が心筋虚血再灌流障害に及ぼす影響-in vivo ウサギモデルにおける検討-.循環制御 20(3):288-293, 1999
19) Orriach JL, Aliaga MR, Ortega MG, et al:Sevoflurane in intraoperative and postoperative cardiac surgery patients. Our experience in intensive care unit with sevoflurane sedation. Curr Pharm Des 19(22):3996-4002, 2013
22) Klein HH, Puschmann S, Schaper J, Schaper W:The mechanism of the Tetrazolium reaction in identifying experimental myocardial infarction, Virchow Arch 393:287-297, 1981
24) Jin C, Wu J, Watanabe M, et al:Mitochondrial K+ channels are involved in ischemic postconditioning in rat hearts. J Physiol Sci 62(4):325-32, 2012
16) Miura T, Imaizumi U, Furuya M, et al:Effects of Ischemic and Sevoflurane-induced Preconditioning on Myocardial Infarction and Arrhythmias in Rabbits In Vivo. J Anesth Clin Res 4:10, 2013
7) Wagner C, Ebner B, Tillack D, et al:Cardioprotection by ischemic postconditioning is abrogated in hypertrophied myocardium of spontaneously hypertensive rats. J Cardiovasc Pharmacol 61(1):35-41, 2013
9) Cope DK, Impastato WK, Cohen MV, et al:Volatile anesthetics protect the ischemic rabbit myocardium from infarction. Anesthesiology 86(3):699-709, 1997
17) Scheller MS, Saidman LJ, Partridge BL:MAC of sevoflurane in humans and the New Zealand white rabbit. Can J Anaesth 35(2):153-156, 1988
15) Sawada H, Yoshida K, Kukreja RC: Blockade of ischemic preconditioning by glibenclamide in rabbits anesthetized with sevoflurane. Bulletin of Kanagawa Dental College 25(2):65-71, 1997
1) Tu L, Pan CS, Wei XH, et al:Astragaloside IV protects heart from ischemia and reperfusion injury via energy regulation mechanism. Microcirculation 20(8):736-747, 2013
5) Onishi A, Miyamae M, Kaneda K, et al:Direct evidence for inhibition of mitochondrial permeability transition pore opening by sevoflurane preconditioning in cardiomyocytes:comparison with cyclosporine A. Eur J Pharmacol 675(1-3):40-46, 2012
14) Kawano T, Oshita S, Takahashi A, et al:Molecular mechanisms underlying ketamine-mediated inhibition of sarcolemmal adenosine triphosphate-sensitive potassium channels. Anesthesiology 102(1):93-101, 2005
18) Piriou V, Mantz J, Goldfarb G, et al:Sevoflurane preconditioning at 1 MAC only provides limited protection in patients undergoing coronary artery bypass surgery:a randomized bi-centre trial. Br J Anaesth 99(5):624-631, 2007
23) Goto M, Miura T, Iliodoromitis EK, O'Leary EL, Ishimoto R, Yellon DM, Iimura O:Adenosine infusion during early reperfusion failed to limit myocardial infarct size in a collateral deficient species, Cardiovasc Res 25(11):943-949, 1991
2) Kojima A, Kitagawa H, Omatsu-Kanbe M, et al:Sevoflurane protects ventricular myocytes against oxidative stress-induced cellular Ca2+ overload and hypercontracture. Anesthesiology 119(3):606-620, 2013
12) De Hert S, Vlasselaers D, Barbe R, et al:A comparison of volatile and non volatile agents for cardioprotection during on-pump coronary surgery. Anaesthesia 64(9):953-960, 2009
6) Yoshida K, Maaieh MM, Shipley JB, et al:Monophosphoryl lipid A induces pharmacologic‘preconditioning’in rabbit hearts without concomitant expression of 70-kDa heat shock protein. Mol Cell Biochem 159(1):73-80, 1996
8) Chen D, Cheng B, Zhou HY, et al:The effect of sevoflurane postconditioning on cardioprotection against ischemia-reperfusion injury in rabbits. Mol Biol Rep 39(5):6049-6057, 2012
20) Piriou V, Chiari P, Lhuillier F, et al:Pharmacological preconditioning:comparison of desflurane, sevoflurane, isoflurane and halothane in rabbit myocardium. Br J Anaesth 89(3):486-491, 2002
References_xml – reference: 9) Cope DK, Impastato WK, Cohen MV, et al:Volatile anesthetics protect the ischemic rabbit myocardium from infarction. Anesthesiology 86(3):699-709, 1997
– reference: 16) Miura T, Imaizumi U, Furuya M, et al:Effects of Ischemic and Sevoflurane-induced Preconditioning on Myocardial Infarction and Arrhythmias in Rabbits In Vivo. J Anesth Clin Res 4:10, 2013
– reference: 2) Kojima A, Kitagawa H, Omatsu-Kanbe M, et al:Sevoflurane protects ventricular myocytes against oxidative stress-induced cellular Ca2+ overload and hypercontracture. Anesthesiology 119(3):606-620, 2013
– reference: 6) Yoshida K, Maaieh MM, Shipley JB, et al:Monophosphoryl lipid A induces pharmacologic‘preconditioning’in rabbit hearts without concomitant expression of 70-kDa heat shock protein. Mol Cell Biochem 159(1):73-80, 1996
– reference: 10) Lamberts RR, Onderwater G, Hamdani N, et al:Reactive oxygen species-induced stimulation of 5'AMP-activated protein kinase mediates sevoflurane-induced cardioprotection. Circulation 120(11):S10-15, 2009
– reference: 22) Klein HH, Puschmann S, Schaper J, Schaper W:The mechanism of the Tetrazolium reaction in identifying experimental myocardial infarction, Virchow Arch 393:287-297, 1981
– reference: 5) Onishi A, Miyamae M, Kaneda K, et al:Direct evidence for inhibition of mitochondrial permeability transition pore opening by sevoflurane preconditioning in cardiomyocytes:comparison with cyclosporine A. Eur J Pharmacol 675(1-3):40-46, 2012
– reference: 1) Tu L, Pan CS, Wei XH, et al:Astragaloside IV protects heart from ischemia and reperfusion injury via energy regulation mechanism. Microcirculation 20(8):736-747, 2013
– reference: 21) Maxwell MP, Hearse DJ, Yellon DM:Species variation in the coronary collateral circulation during regional myocardial ischaemia:a critical determinant of the rate of evolution and extent of myocardial infarction. Cardiovasc Res 21(10):737-746, 1987
– reference: 19) Orriach JL, Aliaga MR, Ortega MG, et al:Sevoflurane in intraoperative and postoperative cardiac surgery patients. Our experience in intensive care unit with sevoflurane sedation. Curr Pharm Des 19(22):3996-4002, 2013
– reference: 24) Jin C, Wu J, Watanabe M, et al:Mitochondrial K+ channels are involved in ischemic postconditioning in rat hearts. J Physiol Sci 62(4):325-32, 2012
– reference: 13) De Hert SG, Van der Linden PJ, Cromheecke S:Choice of primary anesthetic regimen can influence intensive care unit length of stay after coronary surgery with cardiopulmonary bypass. Anesthesiology 101(1):9-20, 2004
– reference: 12) De Hert S, Vlasselaers D, Barbe R, et al:A comparison of volatile and non volatile agents for cardioprotection during on-pump coronary surgery. Anaesthesia 64(9):953-960, 2009
– reference: 18) Piriou V, Mantz J, Goldfarb G, et al:Sevoflurane preconditioning at 1 MAC only provides limited protection in patients undergoing coronary artery bypass surgery:a randomized bi-centre trial. Br J Anaesth 99(5):624-631, 2007
– reference: 8) Chen D, Cheng B, Zhou HY, et al:The effect of sevoflurane postconditioning on cardioprotection against ischemia-reperfusion injury in rabbits. Mol Biol Rep 39(5):6049-6057, 2012
– reference: 17) Scheller MS, Saidman LJ, Partridge BL:MAC of sevoflurane in humans and the New Zealand white rabbit. Can J Anaesth 35(2):153-156, 1988
– reference: 11) 丸山久雄,吉田和市,神田元彦,ほか:揮発性吸入麻酔薬が心筋虚血再灌流障害に及ぼす影響-in vivo ウサギモデルにおける検討-.循環制御 20(3):288-293, 1999
– reference: 20) Piriou V, Chiari P, Lhuillier F, et al:Pharmacological preconditioning:comparison of desflurane, sevoflurane, isoflurane and halothane in rabbit myocardium. Br J Anaesth 89(3):486-491, 2002
– reference: 7) Wagner C, Ebner B, Tillack D, et al:Cardioprotection by ischemic postconditioning is abrogated in hypertrophied myocardium of spontaneously hypertensive rats. J Cardiovasc Pharmacol 61(1):35-41, 2013
– reference: 3) Han Y, Zhao H, Tang H, et al:20-hydroxyeicosatetraenoic Acid mediates isolated heart ischemia/reperfusion injury by increasing NADPH oxidase-derived reactive oxygen species production. Circ J 77(7):1807-1816, 2013
– reference: 15) Sawada H, Yoshida K, Kukreja RC: Blockade of ischemic preconditioning by glibenclamide in rabbits anesthetized with sevoflurane. Bulletin of Kanagawa Dental College 25(2):65-71, 1997
– reference: 23) Goto M, Miura T, Iliodoromitis EK, O'Leary EL, Ishimoto R, Yellon DM, Iimura O:Adenosine infusion during early reperfusion failed to limit myocardial infarct size in a collateral deficient species, Cardiovasc Res 25(11):943-949, 1991
– reference: 4) Murry CE, Jenning RB, Reimer KA:Preconditioning with ischemia:a delay of lethal cell injury in ischemic myocardium. Circulation 74(5):1124-1136, 1986
– reference: 14) Kawano T, Oshita S, Takahashi A, et al:Molecular mechanisms underlying ketamine-mediated inhibition of sarcolemmal adenosine triphosphate-sensitive potassium channels. Anesthesiology 102(1):93-101, 2005
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「要旨」心筋虚血再灌流ウサギモデルにおいて, 心筋壊死縮小効果をもたらすセボフルランの投与方法を検討した. ケタミン/ザイラジン(K/X)で麻酔したコントロール群, さらに1.5%セボフルランを持続投与した群(K/X+1.5S群), 2.1%セボフルランの持続投与群(2.1S群),...
SourceID medicalonline
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SourceType Publisher
StartPage 63
SubjectTerms セボフルラン
心筋保護
虚血再灌流障害
Title 心筋虚血再灌流障害に対するセボフルランによる抑制効果―投与方法による比較検討
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