Opioid preconditioning: myocardial function and energy metabolism.
Ann Thorac Surg
; 72(5): 1576-82, 2001 Nov.
Article
in En
| MEDLINE
| ID: mdl-11722047
ABSTRACT
BACKGROUND:
Opioid receptor agonists are involved in ischemic preconditioning and natural hibernation. The aim of this study was to determine whether pretreatment with D-Ala2-Leu5-enkephalin or morphine confers cardioprotection in large mammalian hearts. We assessed myocardial functional recovery and global energy metabolism after ischemic cold storage.METHODS:
After pretreatment with D-Ala2-Leu5-enkephalin, morphine sulfate, or saline (n = 6 each), swine hearts were excised and stored for 75 minutes at 4 degrees C, then reperfused in a four-chamber isolated working heart apparatus. Serial myocardial biopsies were performed to assess cellular energy metabolism.RESULTS:
Improved systolic (cardiac output, contractility) and diastolic (tau) left ventricular functions were observed in hearts pretreated with D-Ala2-Leu5-enkephalin or morphine. These benefits were not correlated with changes in high-energy phosphate levels. Cardiac enzyme leakage (creatine kinase, troponin-I) was similar among treated and control groups. Lactate efflux increased significantly in controls, but not in opioid-pretreated hearts (p < 0.01) at 75 minutes of reperfusion.CONCLUSIONS:
D-Ala2-Leu5-enkephalin and morphine pretreatments improve postischemic function after cold storage of swine hearts. Postischemic lactate reduction, but not high-energy phosphate levels, may account for the observed cardioprotective effects.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Enkephalin, Leucine-2-Alanine
/
Ischemic Preconditioning, Myocardial
/
Energy Metabolism
/
Morphine
/
Myocardium
Limits:
Animals
Language:
En
Journal:
Ann Thorac Surg
Year:
2001
Document type:
Article
Affiliation country:
Estados Unidos