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British Journal of Anaesthesia, 2002, Vol. 88, No. 1 87-93
© 2002 The Board of Management and Trustees of the British Journal of Anaesthesia

Laboratory Investigations

Naloxone prevents increased atrial natriuretic peptide release during regional myocardial ischaemia and stunning in awake dogs

T. P. Weber1, C. Raufhake1, M. A. Große Hartlage1, N. Rolf1, J. Stypmann2, H. Van Aken1, E. Berendes1 and A. Meißner1

1Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Westfälische Wilhelms-Universität Münster, Albert-Schweitzerstrasse 33, D-48149 Münster, Germany. 2Klinik und Poliklinik für Kardiologie und Angiologie, Innere Medizin C, Westfälische Wilhelms-Universität Münster, Münster, Germany*Corresponding author

Background. Atrial natriuretic peptide (ANP) release is increased in patients with ischaemic left ventricular dysfunction. A beneficial effect of naloxone on recovery from myocardial stunning was shown previously. The aim of this study was to investigate the effects of naloxone on ANP release during regional myocardial ischaemia and stunning in awake dogs.

Methods. Ten dogs were chronically instrumented for measurement of heart rate, left atrial, aortic, and left ventricular pressure (LVP), LV dP·dtmax/min–1, and myocardial wall-thickening fraction. An occluder around the left anterior descending artery (LAD) allowed induction of reversible ischaemia in the LAD-perfused myocardium. Each dog underwent two ischaemic episodes (randomized crossover fashion; separate days): 10 min of LAD occlusion (1) after application of naloxone (63 µg kg–1), and (2) without naloxone. ANP levels were measured at baseline (BL) and at predetermined time points until complete recovery of myocardial stunning occurred.

Results. LAD ischaemia-induced release of ANP (peak level: 182 (30) vs 27 (7) pg ml–1 BL) only in the control group without naloxone. Between 1 and 180 min of reperfusion, ANP levels were significantly higher only in the control group (P<0.05).

Conclusion. Pre-ischaemic application of naloxone prevents this ischaemia-induced ANP-release in conscious dogs.

Br J Anaesth 2002; 88: 87–93


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