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Marques AEGW, Marques MG, Silveira BCR, Oliveira SP, Ferraz IG, Ventricci ABG, Silva NC, Nagata WB, Floriano BP, Ferreira WL, Santos PSP. Lidocaine administered at a continuous rate infusion does not impair left ventricular systolic and diastolic function of healthy rabbits sedated with midazolam. Vet Anim Sci 2020; 10:100151. [PMID: 33117910 PMCID: PMC7581963 DOI: 10.1016/j.vas.2020.100151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 11/25/2022] Open
Abstract
Lidocaine is a versatile drug that not only provides local anesthesia, but also reduces anesthetic requirements of other agents and has antiarrhythmic, pro-kinetic, anti-inflammatory, antiendotoxemic and antioxidant effects. As it is a drug commonly used in critically ill patients, its safety from the cardiovascular system should be ensured. The aim of this study was to determine the effects of a continuous rate infusion (CRI) of lidocaine on left ventricular systolic and diastolic function of healthy rabbits sedated with midazolam by use of transthoracic echocardiography. Ten New Zealand healthy rabbits were sedated with intramuscular midazolam (1 mg/kg) and enrolled in two experimental treatments (control or lidocaine). The control treatment (CT) comprised an intravenous bolus of 0.9% sodium chloride (0.05 mL/kg) followed by CRI at 5 mL/h, whereas the lidocaine treatment (LT) comprised a bolus of 2% lidocaine without epinephrine at 1 mg/kg followed by CRI at 50 µg/kg/minute. Echocardiographic and hemodynamic variables were studied. Variables were recorded at baseline (TB) and 20, 40 and 60 minutes following start of CRI (T20, T40 and T60, respectively). No differences were found between treatments. The results of this study demonstrate that a continuous rate infusion of lidocaine at 50 µg/kg/minute does not impair echocardiographic indices of left ventricular systolic and diastolic function of healthy rabbits sedated with midazolam.
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Affiliation(s)
- A E G W Marques
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
| | - M G Marques
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil.,Department of Veterinary Medicine, University Center of the Integrated Colleges of Ourinhos (UniFio), BR 153, Km 338+420m, 19909-100, Ourinhos, São Paulo State, Brazil
| | - B C R Silveira
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
| | - S P Oliveira
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
| | - I G Ferraz
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
| | - A B G Ventricci
- Department of Veterinary Medicine, University Center of the Integrated Colleges of Ourinhos (UniFio), BR 153, Km 338+420m, 19909-100, Ourinhos, São Paulo State, Brazil
| | - N C Silva
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
| | - W B Nagata
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
| | - B P Floriano
- Department of Veterinary Medicine, University Center of the Integrated Colleges of Ourinhos (UniFio), BR 153, Km 338+420m, 19909-100, Ourinhos, São Paulo State, Brazil
| | - W L Ferreira
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
| | - P S P Santos
- Department of Animal Clinic, Surgery and Reproduction, São Paulo State University (UNESP), School of Veterinary Medicine, 793 Clovis Pestana st., 16050-680, Araçatuba, São Paulo State, Brazil
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Mosqueira M, Aykut G, Fink RHA. Mepivacaine reduces calcium transients in isolated murine ventricular cardiomyocytes. BMC Anesthesiol 2020; 20:10. [PMID: 31914932 PMCID: PMC6947945 DOI: 10.1186/s12871-019-0926-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/30/2019] [Indexed: 12/14/2022] Open
Abstract
Background The potential mechanism of mepivacaine’s myocardial depressant effect observed in papillary muscle has not yet been investigated at cellular level. Therefore, we evaluated mepivacaine’s effects on Ca2+ transient in isolated adult mouse cardiomyocytes. Methods Single ventricular myocytes were enzymatically isolated from wild-type C57Bl/6 mice and loaded with 10 μM fluorescent Ca2+ indicator Fluo-4-AM to record intracellular Ca2+ transients upon electrical stimulation. The mepivacaine effects at half-maximal inhibitory concentration (IC50) was determined on calibrated cardiomyocytes’ Ca2+ transients by non-parametric statistical analyses on biophysical parameters. Combination of mepivacaine with NCX blockers ORM-10103 or NiCl2 were used to test a possible mechanism to explain mepivacaine-induced Ca2+ transients’ reduction. Results A significant inhibition at mepivacaine’s IC50 (50 μM) on Ca2+ transients was measured in biophysical parameters such as peak (control: 528.6 ± 73.61 nM vs mepivacaine: 130.9 ± 15.63 nM; p < 0.05), peak area (control: 401.7 ± 63.09 nM*s vs mepivacaine: 72.14 ± 10.46 nM*s; p < 0.05), slope (control: 7699 ± 1110 nM/s vs mepivacaine: 1686 ± 226.6 nM/s; p < 0.05), time to peak (control: 107.9 ± 8.967 ms vs mepivacaine: 83.61 ± 7.650 ms; p < 0.05) and D50 (control: 457.1 ± 47.16 ms vs mepivacaine: 284.5 ± 22.71 ms; p < 0.05). Combination of mepivacaine with NCX blockers ORM-10103 or NiCl2 showed a significant increase in the baseline of [Ca2+] and arrhythmic activity upon electrical stimulation. Conclusion At cellular level, mepivacaine blocks Na+ channels, enhancing the reverse mode activity of NCX, leading to a significant reduction of Ca2+ transients. These results suggest a new mechanism for the mepivacaine-reduction contractility effect.
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Affiliation(s)
- Matias Mosqueira
- Cardio-Ventilatory Muscle Physiology Laboratory, Institute of Physiology and Pathophysiology, Heidelberg University Hospital, Im Neuenheimer Feld 326, 69120, Heidelberg, Germany.
| | - Güçlü Aykut
- Cardio-Ventilatory Muscle Physiology Laboratory, Institute of Physiology and Pathophysiology, Heidelberg University Hospital, Im Neuenheimer Feld 326, 69120, Heidelberg, Germany
| | - Rainer H A Fink
- Cardio-Ventilatory Muscle Physiology Laboratory, Institute of Physiology and Pathophysiology, Heidelberg University Hospital, Im Neuenheimer Feld 326, 69120, Heidelberg, Germany
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Mannhardt I, Eder A, Dumotier B, Prondzynski M, Krämer E, Traebert M, Söhren KD, Flenner F, Stathopoulou K, Lemoine MD, Carrier L, Christ T, Eschenhagen T, Hansen A. Blinded Contractility Analysis in hiPSC-Cardiomyocytes in Engineered Heart Tissue Format: Comparison With Human Atrial Trabeculae. Toxicol Sci 2018; 158:164-175. [PMID: 28453742 PMCID: PMC5837217 DOI: 10.1093/toxsci/kfx081] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) may serve as a new assay for drug testing in a human context, but their validity particularly for the evaluation of inotropic drug effects remains unclear. In this blinded analysis, we compared the effects of 10 indicator compounds with known inotropic effects in electrically stimulated (1.5 Hz) hiPSC-CM-derived 3-dimensional engineered heart tissue (EHT) and human atrial trabeculae (hAT). Human EHTs were prepared from iCell hiPSC-CM, hAT obtained at routine heart surgery. Mean intra-batch variation coefficient in baseline force measurement was 17% for EHT and 49% for hAT. The PDE-inhibitor milrinone did not affect EHT contraction force, but increased force in hAT. Citalopram (selective serotonin reuptake inhibitor), nifedipine (LTCC-blocker) and lidocaine (Na+ channel-blocker) had negative inotropic effects on EHT and hAT. Formoterol (beta-2 agonist) had positive lusitropic but no inotropic effect in EHT, and positive clinotropic, lusitropic, and inotropic effects in hAT. Tacrolimus (calcineurin-inhibitor) had a negative inotropic effect in EHTs, but no effect in hAT. Digoxin (Na+-K+-ATPase-inhibitor) showed a positive inotropic effect only in EHTs, but no effect in hAT probably due to short incubation time. Ryanodine (ryanodine receptor-inhibitor) reduced contraction force in both models. Rolipram and acetylsalicylic acid showed noninterpretable results in hAT. Contraction amplitude and kinetics were more stable over time and less variable in hiPSC-EHTs than hAT. HiPSC-EHT faithfully detected cAMP-dependent and -independent positive and negative inotropic effects, but limited beta-2 adrenergic or PDE3 effects, compatible with an immature CM phenotype.
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Affiliation(s)
- Ingra Mannhardt
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Alexandra Eder
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | | | - Maksymilian Prondzynski
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Elisabeth Krämer
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | | | - Klaus-Dieter Söhren
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Frederik Flenner
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Konstantina Stathopoulou
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Marc D Lemoine
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany.,Department of Cardiology-Electrophysiology, University Heart Center, 20246 Hamburg, Germany
| | - Lucie Carrier
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Torsten Christ
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Thomas Eschenhagen
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
| | - Arne Hansen
- Department of Experimental Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, 20246 Hamburg, Germany
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Pinotti MF, Hepner A, Campos DHS, Silva LM, Cicogna AC, Ganem EM. Myocardial contractility impairment with racemic bupivacaine, non-racemic bupivacaine and ropivacaine. A comparative study. Acta Cir Bras 2015; 30:484-90. [PMID: 26270140 DOI: 10.1590/s0102-865020150070000006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/22/2015] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To study racemic bupivacaine, non-racemic bupivacaine and ropivacaine on myocardial contractility. METHODS Isolated Wistar papillary muscles were submitted to 50 and 100 mM racemic bupivacaine (B50 and B100), non-racemic bupivacaine (NR50 and NR100) and ropivacaine (R50 and R100) intoxication. Isometric contraction data were obtained in basal condition (0.2 Hz), after increasing the frequency of stimulation to 1.0 Hz and after 5, 10 and 15 min of local anesthetic intoxication. Data were analyzed as relative changes of variation. RESULTS Developed tension was higher with R100 than B100 at D1 (4.3 ± 41.1 vs -57.9 ± 48.1). Resting tension was altered with B50 (-10.6 ± 23.8 vs -4.7 ± 5.0) and R50 (-14.0 ± 20.5 vs -0.5 ± 7.1) between D1 and D3. Maximum rate of tension development was lower with B100 (-56.6 ± 38.0) than R50 (-6.3 ± 37.9) and R100 (-1.9 ± 37.2) in D1. B50, B100 and NR100 modified the maximum rate of tension decline from D1 through D2. Time to peak tension was changed with NR50 between D1 and D2. CONCLUSIONS Racemic bupivacaine depressed myocardial contractile force more than non-racemic bupivacaine and ropivacaine. Non-racemic and racemic bupivacaine caused myocardial relaxation impairment more than ropivacaine.
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Affiliation(s)
- Matheus Fécchio Pinotti
- Department of Anesthesiology, Botucatu School of Medicine, Universidade Estadual de São Paulo, São Paulo, Brazil
| | - Adriana Hepner
- Department of Anesthesiology, Botucatu School of Medicine, UNESP, Botucatu, SP, Brazil
| | | | - Leopoldo Muniz Silva
- Department of Anesthesiology, Botucatu School of Medicine, UNESP, Botucatu, SP, Brazil
| | - Antonio Carlos Cicogna
- Department of Internal Medicine, Botucatu School of Medicine, UNESP, Botucatu, SP, Brazil
| | - Eliana Marisa Ganem
- Department of Anesthesiology, Botucatu School of Medicine, UNESP, Botucatu, SP, Brazil
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Dobson GP, Faggian G, Onorati F, Vinten-Johansen J. Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era? Front Physiol 2013; 4:228. [PMID: 24009586 PMCID: PMC3755226 DOI: 10.3389/fphys.2013.00228] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 08/05/2013] [Indexed: 12/16/2022] Open
Abstract
Despite surgical proficiency and innovation driving low mortality rates in cardiac surgery, the disease severity, comorbidity rate, and operative procedural difficulty have increased. Today's cardiac surgery patient is older, has a "sicker" heart and often presents with multiple comorbidities; a scenario that was relatively rare 20 years ago. The global challenge has been to find new ways to make surgery safer for the patient and more predictable for the surgeon. A confounding factor that may influence clinical outcome is high K(+) cardioplegia. For over 40 years, potassium depolarization has been linked to transmembrane ionic imbalances, arrhythmias and conduction disturbances, vasoconstriction, coronary spasm, contractile stunning, and low output syndrome. Other than inducing rapid electrochemical arrest, high K(+) cardioplegia offers little or no inherent protection to adult or pediatric patients. This review provides a brief history of high K(+) cardioplegia, five areas of increasing concern with prolonged membrane K(+) depolarization, and the basic science and clinical data underpinning a new normokalemic, "polarizing" cardioplegia comprising adenosine and lidocaine (AL) with magnesium (Mg(2+)) (ALM™). We argue that improved cardioprotection, better outcomes, faster recoveries and lower healthcare costs are achievable and, despite the early predictions from the stent industry and cardiology, the "cath lab" may not be the place where the new wave of high-risk morbid patients are best served.
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Affiliation(s)
- Geoffrey P. Dobson
- Department of Physiology and Pharmacology, Heart and Trauma Research Laboratory, James Cook UniversityTownsville, QLD, Australia
| | - Giuseppe Faggian
- Division of Cardiac Surgery, University of Verona Medical SchoolVerona, Italy
| | - Francesco Onorati
- Division of Cardiac Surgery, University of Verona Medical SchoolVerona, Italy
| | - Jakob Vinten-Johansen
- Cardiothoracic Research Laboratory of Emory University Hospital Midtown, Carlyle Fraser Heart CenterAtlanta, GA, USA
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Krzemiński TF, Mitręga K, Żorniak M, Porc M. Differential effects of four xylidine derivatives in the model of ischemia- and re-perfusion-induced arrhythmias in rats in vivo. Eur J Pharmacol 2010; 644:120-7. [DOI: 10.1016/j.ejphar.2010.06.036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 05/26/2010] [Accepted: 06/21/2010] [Indexed: 11/25/2022]
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