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Uhlig C, Labus J. Volatile Versus Intravenous Anesthetics in Cardiac Anesthesia: a Narrative Review. CURRENT ANESTHESIOLOGY REPORTS 2021; 11:275-283. [PMID: 34276252 PMCID: PMC8271298 DOI: 10.1007/s40140-021-00466-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 11/25/2022]
Abstract
Purpose of the Review The present review addresses clinicians and gives an overview about the experimental rationale for pharmacological conditioning associated with volatile anesthetics, opioids, and propofol; the current clinical data; and the technical considerations regarding the clinical routine in cardiac anesthesia. Recent Findings Volatile anesthetics have been standard of care for general anesthesia for cardiac surgery, especially while using cardiopulmonary bypass. The 2019 published MYRIAD trial was not able to show a difference in mortality or cardiac biomarkers for volatile anesthetics compared to total intravenous anesthesia (TIVA), raising the question of equivalence with respect to patient outcome. Summary Reviewing the literature, the scientific foundation for the belief of clinically relevant conditioning by uninterrupted administration of a volatile anesthetic is weak. TIVA can also be performed safely in patients undergoing cardiac surgery.
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Affiliation(s)
- Christopher Uhlig
- Department of Cardiac Anesthesiology, Heart Center Dresden University Hospital, Fetscherstr. 76, 01307 Dresden, Germany
| | - Jakob Labus
- Department of Anesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty, Cologne University, Albertus-Magnus-Platz, 50923 Cologne, Germany
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2
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Afanas'ev SА, Muslimova EF, Rebrova ТY, Tsapko LP, Kercheva МА, Golubenko МV. Peculiarities of the Functional State of Mitochondria of Peripheral Blood Leukocytes in Patients with Acute Myocardial Infarction. Bull Exp Biol Med 2020; 169:435-437. [PMID: 32889567 DOI: 10.1007/s10517-020-04903-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Indexed: 10/23/2022]
Abstract
We studied the rate of oxygen consumption by mitochondria isolated from peripheral blood leukocytes of patients with acute myocardial infarction and healthy volunteers. It was found that leukocyte mitochondria in patients with acute myocardial infarction were characterized by significantly lower rate of oxygen consumption and lower level of coupling of oxidation and phosphorylation processes in comparison with mitochondria from healthy volunteers.
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Affiliation(s)
| | | | | | - L P Tsapko
- Сardiology Research Institute, Тomsk, Russia
| | | | - М V Golubenko
- Research Institute of Medical Genetics, Тomsk National Research Medical Center, Russian Academy of Sciences, Тomsk, Russia
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Guo S, Kong J, Zhou D, Lai M, Chen Y, Xie D, Wang X, Wang D. Serum metabolic characteristics and biomarkers of early-stage heart failure. Biomark Med 2020; 14:119-130. [PMID: 32057273 DOI: 10.2217/bmm-2019-0176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Aim: We aimed to identify metabolic characteristics of early-stage heart failure (HF) and related biomarkers. Patients & methods: One hundred and forty-three patients with New York Heart Association class I-IV HF and 34 healthy controls were recruited. Serum metabolic characteristics of class I HF were analyzed and compared with those of class II-IV HF. Potential biomarkers of class I HF with normal N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level were screened and validated in additional 72 subjects (46 class I patients and 26 controls). Results & conclusion: Eleven metabolites were found disturbed in class I HF, and five of which were also disturbed in class II-IV HF. Glutamine and tyrosine showed high value to identify class I HF with normal NT-proBNP level. The diagnostic potential of glutamine was partially confirmed in the validate set, holding a promise to detect early HF with normal NT-proBNP level.
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Affiliation(s)
- Siqi Guo
- First Affiliated Hospital, Shantou University Medical College, Shantou 515041, China
| | - Jing Kong
- Department of Forensic Medicine, Shantou University Medical College, Shantou 515041, China
| | - Danya Zhou
- Department of Forensic Medicine, Shantou University Medical College, Shantou 515041, China
| | - Minchao Lai
- First Affiliated Hospital, Shantou University Medical College, Shantou 515041, China
| | - Yirun Chen
- Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China
| | - Dezhi Xie
- Department of Forensic Medicine, Shantou University Medical College, Shantou 515041, China
| | | | - Dian Wang
- Department of Forensic Medicine, Shantou University Medical College, Shantou 515041, China
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Badimon L, Mendieta G, Ben-Aicha S, Vilahur G. Post-Genomic Methodologies and Preclinical Animal Models: Chances for the Translation of Cardioprotection to the Clinic. Int J Mol Sci 2019; 20:ijms20030514. [PMID: 30691061 PMCID: PMC6387468 DOI: 10.3390/ijms20030514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/23/2019] [Indexed: 12/02/2022] Open
Abstract
Although many cardioprotective strategies have demonstrated benefits in animal models of myocardial infarction, they have failed to demonstrate cardioprotection in the clinical setting highlighting that new therapeutic target and treatment strategies aimed at reducing infarct size are urgently needed. Completion of the Human Genome Project in 2001 fostered the post-genomic research era with the consequent development of high-throughput “omics” platforms including transcriptomics, proteomics, and metabolomics. Implementation of these holistic approaches within the field of cardioprotection has enlarged our understanding of ischemia/reperfusion injury with each approach capturing a different angle of the global picture of the disease. It has also contributed to identify potential prognostic/diagnostic biomarkers and discover novel molecular therapeutic targets. In this latter regard, “omic” data analysis in the setting of ischemic conditioning has allowed depicting potential therapeutic candidates, including non-coding RNAs and molecular chaperones, amenable to pharmacological development. Such discoveries must be tested and validated in a relevant and reliable myocardial infarction animal model before moving towards the clinical setting. Moreover, efforts should also focus on integrating all “omic” datasets rather than working exclusively on a single “omic” approach. In the following manuscript, we will discuss the power of implementing “omic” approaches in preclinical animal models to identify novel molecular targets for cardioprotection of interest for drug development.
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Affiliation(s)
- Lina Badimon
- Cardiovascular Program- ICCC, Research Institute-Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain. (L.B.).
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV) Instituto de Salud Carlos III, 28029 Madrid, Spain..
- Cardiovascular Research Chair, Universidad Autónoma Barcelona (UAB) 08025 Barcelona, Spain.
| | - Guiomar Mendieta
- Cardiovascular Program- ICCC, Research Institute-Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain. (L.B.).
- Department of Cardiology, Hospital Clinic, 08036 Brcelona, Spain.
| | - Soumaya Ben-Aicha
- Cardiovascular Program- ICCC, Research Institute-Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain. (L.B.).
| | - Gemma Vilahur
- Cardiovascular Program- ICCC, Research Institute-Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, 08025 Barcelona, Spain. (L.B.).
- Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV) Instituto de Salud Carlos III, 28029 Madrid, Spain..
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Cho K, Min SI, Ahn S, Min SK, Ahn C, Yu KS, Jang IJ, Cho JY, Ha J. Integrative Analysis of Renal Ischemia/Reperfusion Injury and Remote Ischemic Preconditioning in Mice. J Proteome Res 2017. [PMID: 28627174 DOI: 10.1021/acs.jproteome.7b00167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Remote ischemic preconditioning (RIPC) is a strategy to induce resistance in a target organ against the oxidative stress and injury caused by ischemia and reperfusion (IR). RIPC harnesses the body's endogenous protective capabilities through brief episodes of IR applied in organs remote from the target. Few studies have analyzed this phenomenon in the kidney. Furthermore, the window of protection representing RIPC efficacy has not been fully elucidated. Here, we performed a multiomics study to specify those associated with protective effects of RIPC against the IR injury. A total of 30 mice were divided to four groups: sham, IR only, late RIPC + IR, and early RIPC + IR. We found that IR clearly led to tubular injury, whereas both preconditioning groups exhibited attenuated injury after the insult. In addition, renal IR injury produced changes of the metabolome in kidney, serum, and urine specimens. Furthermore, distinctive mRNA and associated protein expression changes supported potential mechanisms. Our findings revealed that RIPC effectively reduces renal damage after IR and that the potential mechanisms differed between the two time windows of protection. These results may potentially be extended to humans to allow non- or minimally invasive diagnosis of renal IR injury and RIPC efficacy.
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Affiliation(s)
- Kumsun Cho
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine , Seoul 03080, Republic of Korea.,Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital , Seoul 03080, Republic of Korea
| | - Sang-Il Min
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine , Seoul 03080, Republic of Korea.,Department of Surgery, Seoul National University College of Medicine , Seoul 03080, Republic of Korea
| | - Sanghyun Ahn
- Department of Surgery, Seoul National University College of Medicine , Seoul 03080, Republic of Korea
| | - Seung-Kee Min
- Department of Surgery, Seoul National University College of Medicine , Seoul 03080, Republic of Korea
| | - Curie Ahn
- Department of Internal Medicine, Seoul National University College of Medicine , Seoul 03080, Republic of Korea
| | - Kyung-Sang Yu
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine , Seoul 03080, Republic of Korea.,Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital , Seoul 03080, Republic of Korea
| | - In-Jin Jang
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine , Seoul 03080, Republic of Korea.,Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital , Seoul 03080, Republic of Korea
| | - Joo-Youn Cho
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine , Seoul 03080, Republic of Korea.,Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital , Seoul 03080, Republic of Korea
| | - Jongwon Ha
- Metabolomics Medical Research Center (MMRC), Seoul National University College of Medicine , Seoul 03080, Republic of Korea.,Department of Surgery, Seoul National University College of Medicine , Seoul 03080, Republic of Korea
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Mintzopoulos D, Gillis TE, Tedford CE, Kaufman MJ. Effects of Near-Infrared Light on Cerebral Bioenergetics Measured with Phosphorus Magnetic Resonance Spectroscopy. Photomed Laser Surg 2017; 35:395-400. [PMID: 28186868 DOI: 10.1089/pho.2016.4238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Cerebral photobiomodulation (PBM) improves mood and cognition. Cerebral metabolic enhancement is a mechanism proposed to underlie PBM effects. No PBM studies to date have applied phosphorus magnetic resonance spectroscopy (31P MRS), which can be used to assess metabolic intermediates such as phosphocreatine (PCr) and adenosine triphosphate, the latter of which is elevated by PBM. Accordingly, we used 9.4 Tesla 31P MRS to characterize effects of single and repeat cerebral PBM treatments on metabolism. PBM was delivered to healthy adult beagles in the form of transcranial laser treatment (TLT) at a wavelength of 808 nm, which passes safely through the skull and activates cytochrome C oxidase, a mitochondrial respiratory chain enzyme. METHODS Isoflurane-anesthetized subjects (n = 4) underwent a baseline 31P MRS scan followed by TLT applied sequentially for 2 min each to anterior and posterior cranium midline locations, to irradiate the dorsal cortex. Subjects then underwent 31P MRS scans for 2 h to assess acute TLT effects. After 2 weeks of repeat TLT (3 times/week), subjects were scanned again with 31P MRS to characterize effects of repeat TLT. RESULTS TLT did not induce acute 31P MRS changes over the course of 2 h in either scan session. However, after repeat TLT, the baseline PCr/β-nucleoside triphosphate ratio was higher than the scan 1 baseline (p < 0.0001), an effect attributable to increased PCr level (p < 0.0001). CONCLUSIONS Our findings are consistent with reports that bioenergetic effects of PBM can take several hours to evolve. Thus, in vivo 31P MRS may be useful for characterizing bioenergetic effects of PBM in brain and other tissues.
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Affiliation(s)
| | - Timothy E Gillis
- 1 McLean Imaging Center , McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | | | - Marc J Kaufman
- 1 McLean Imaging Center , McLean Hospital, Harvard Medical School, Belmont, Massachusetts
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Comparative analysis of resuscitation using human serum albumin and crystalloids or 130/0.4 hydroxyethyl starch and crystalloids on skeletal muscle metabolic profile during experimental haemorrhagic shock in swine. Eur J Anaesthesiol 2017; 34:89-97. [DOI: 10.1097/eja.0000000000000537] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Bayeva M, Sawicki KT, Butler J, Gheorghiade M, Ardehali H. Molecular and cellular basis of viable dysfunctional myocardium. Circ Heart Fail 2014; 7:680-91. [PMID: 25028350 DOI: 10.1161/circheartfailure.113.000912] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Marina Bayeva
- From the Division of Cardiology, Department of Medicine, Northwestern University School of Medicine, Chicago, IL (M.B., K.T.S., M.G., H.A.); and Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA (J.B.)
| | - Konrad Teodor Sawicki
- From the Division of Cardiology, Department of Medicine, Northwestern University School of Medicine, Chicago, IL (M.B., K.T.S., M.G., H.A.); and Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA (J.B.)
| | - Javed Butler
- From the Division of Cardiology, Department of Medicine, Northwestern University School of Medicine, Chicago, IL (M.B., K.T.S., M.G., H.A.); and Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA (J.B.)
| | - Mihai Gheorghiade
- From the Division of Cardiology, Department of Medicine, Northwestern University School of Medicine, Chicago, IL (M.B., K.T.S., M.G., H.A.); and Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA (J.B.)
| | - Hossein Ardehali
- From the Division of Cardiology, Department of Medicine, Northwestern University School of Medicine, Chicago, IL (M.B., K.T.S., M.G., H.A.); and Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA (J.B.).
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