British Journal of Anaesthesia, 2003, Vol. 91, No. 4 551-565
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia
Review Article |
Anaesthetics and cardiac preconditioning. Part I. Signalling and cytoprotective mechanisms
1 Institute of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland. 2 Institute of Pharmacology and Toxicology, University of Zurich, Zurich, Switzerland
Corresponding author: E-mail: michael.zaugg@usz.ch
Abstract
Cardiac preconditioning represents the most potent and consistently reproducible method of rescuing heart tissue from undergoing irreversible ischaemic damage. Major milestones regarding the elucidation of this phenomenon have been passed in the last two decades. The signalling and amplification cascades from the preconditioning stimulus, be it ischaemic or pharmacological, to the putative end-effectors, including the mechanisms involved in cellular protection, are discussed in this review. Volatile anaesthetics and opioids effectively elicit pharmacological preconditioning. Anaesthetic-induced preconditioning and ischaemic preconditioning share many fundamental steps, including activation of G-protein-coupled receptors, multiple protein kinases and ATP-sensitive potassium channels (KATP channels). Volatile anaesthetics prime the activation of the sarcolemmal and mitochondrial KATP channels, the putative end-effectors of preconditioning, by stimulation of adenosine receptors and subsequent activation of protein kinase C (PKC) and by increased formation of nitric oxide and free oxygen radicals. In the case of desflurane, stimulation of 
- and ß-adrenergic receptors may also be of importance. Similarly, opioids activate 
- and 
-opioid receptors, and this also leads to PKC activation. Activated PKC acts as an amplifier of the preconditioning stimulus and stabilizes, by phosphorylation, the open state of the mitochondrial KATP channel (the main end-effector in anaesthetic preconditioning) and the sarcolemmal KATP channel. The opening of KATP channels ultimately elicits cytoprotection by decreasing cytosolic and mitochondrial Ca2+ overload.
Br J Anaesth 2003; 91: 551–65
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  E. Lucchinetti, J. Wacker, C. Maurer, M. Keel, L. Harter, K. Zaugg, and M. Zaugg Helium Breathing Provides Modest Antiinflammatory, but No Endothelial Protection Against Ischemia-Reperfusion Injury in Humans In Vivo Anesth. Analg., July 1, 2009; 109(1): 101 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. W. Sturesson, A. Johansson, M. Bodelsson, and G. Malmkvist Wash-in kinetics for sevoflurane using a disposable delivery system (AnaConDa(R)) in cardiac surgery patients Br. J. Anaesth., April 1, 2009; 102(4): 470 - 476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Huffmyer and J. Raphael Physiology and Pharmacology of Myocardial Preconditioning and Postconditioning Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2009; 13(1): 5 - 18. [Abstract] [PDF]
|
|
|
|
|
|
L. J. Velly, P. T. Canas, B. A. Guillet, C. N. Labrande, F. M. Masmejean, A. L. Nieoullon, F. M. Gouin, N. J. Bruder, and P. S. Pisano Early Anesthetic Preconditioning in Mixed Cortical Neuronal-Glial Cell Cultures Subjected to Oxygen-Glucose Deprivation: The Role of Adenosine Triphosphate Dependent Potassium Channels and Reactive Oxygen Species in Sevoflurane-Induced Neuroprotection Anesth. Analg., March 1, 2009; 108(3): 955 - 963. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. S. Pagel Induction of Heat Shock Protein 70 and Preconditioning by Sevoflurane: A Potent Protective Interaction Against Myocardial Ischemia-Reperfusion Injury Anesth. Analg., September 1, 2008; 107(3): 742 - 745. [Full Text] [PDF]
|
|
|
|
|
|
H. Wang, Z. Xue, Q. Wang, X. Feng, and Z. Shen Propofol Protects Hepatic L02 Cells from Hydrogen Peroxide-Induced Apoptosis via Activation of Extracellular Signal-Regulated Kinases Pathway Anesth. Analg., August 1, 2008; 107(2): 534 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Li, X. Zhang, B. Zhu, and Z. Xue Desflurane Preconditioning Inhibits Endothelial Nuclear Factor-{kappa}-B Activation by Targeting the Proximal End of Tumor Necrosis Factor-{alpha} Signaling Anesth. Analg., May 1, 2008; 106(5): 1473 - 1479. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kaneda, M. Miyamae, S. Sugioka, C. Okusa, Y. Inamura, N. Domae, J. Kotani, and V. M. Figueredo Sevoflurane Enhances Ethanol-Induced Cardiac Preconditioning Through Modulation of Protein Kinase C, Mitochondrial KATP Channels, and Nitric Oxide Synthase, in Guinea Pig Hearts Anesth. Analg., January 1, 2008; 106(1): 9 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Zaugg Is protection by inhalation agents volatile? Controversies in cardioprotection Br. J. Anaesth., November 1, 2007; 99(5): 603 - 606. [Full Text] [PDF]
|
|
|
|
|
|
R. A. Bouwman, R. J. P. Musters, B. J. van Beek-Harmsen, J. J. de Lange, R. R. Lamberts, S. A. Loer, and C. Boer Sevoflurane-induced cardioprotection depends on PKC-{alpha} activation via production of reactive oxygen species Br. J. Anaesth., November 1, 2007; 99(5): 639 - 645. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Piriou, J. Mantz, G. Goldfarb, M. Kitakaze, P. Chiari, S. Paquin, C. Cornu, J.-B. Lecharny, P. Aussage, E. Vicaut, 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., November 1, 2007; 99(5): 624 - 631. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. An, Z. J. Bosnjak, and M. T. Jiang Myocardial Protection by Isoflurane Preconditioning Preserves Ca2+ Cycling Proteins Independent of Sarcolemmal and Mitochondrial KATP Channels Anesth. Analg., November 1, 2007; 105(5): 1207 - 1213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. T. Jiang, Y. Nakae, M. Ljubkovic, W.-M. Kwok, D. F. Stowe, and Z. J. Bosnjak Isoflurane Activates Human Cardiac Mitochondrial Adenosine Triphosphate-Sensitive K+ Channels Reconstituted in Lipid Bilayers Anesth. Analg., October 1, 2007; 105(4): 926 - 932. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. I. Deyhimy, N. W. Fleming, I. G. Brodkin, and H. Liu Anesthetic Preconditioning Combined with Postconditioning Offers No Additional Benefit Over Preconditioning or Postconditioning Alone Anesth. Analg., August 1, 2007; 105(2): 316 - 324. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Annecke, J. C. Kubitz, S. Kahr, J. M. Hilberath, K. Langer, G. I. Kemming, M. Rehm, I. Bittmann, and P. F. Conzen Effects of sevoflurane and propofol on ischaemia-reperfusion injury after thoracic-aortic occlusion in pigs Br. J. Anaesth., May 1, 2007; 98(5): 581 - 590. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. C. Lee, H. C. Wen, C. P. Chang, M. Y. Chen, and M. T. Lin Heat shock protein 72 overexpression protects against hyperthermia, circulatory shock, and cerebral ischemia during heatstroke J Appl Physiol, June 1, 2006; 100(6): 2073 - 2082. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Lutz and H. Liu Inhaled sevoflurane produces better delayed myocardial protection at 48 versus 24 hours after exposure. Anesth. Analg., April 1, 2006; 102(4): 984 - 990. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Bovill Intravenous Anesthesia for the Patient with Left Ventricular Dysfunction Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2006; 10(1): 43 - 48. [Abstract] [PDF]
|
|
|
|
|
|
J. Raphael, J. Rivo, and Y. Gozal Isoflurane-induced myocardial preconditioning is dependent on phosphatidylinositol-3-kinase/Akt signalling Br. J. Anaesth., December 1, 2005; 95(6): 756 - 763. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Riess, A. K. S. Camara, S. S. Rhodes, J. McCormick, M. T. Jiang, and D. F. Stowe Increasing Heart Size and Age Attenuate Anesthetic Preconditioning in Guinea Pig Isolated Hearts Anesth. Analg., December 1, 2005; 101(6): 1572 - 1576. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Lucchinetti, R. da Silva, T. Pasch, M. C. Schaub, and M. Zaugg Anaesthetic preconditioning but not postconditioning prevents early activation of the deleterious cardiac remodelling programme: evidence of opposing genomic responses in cardioprotection by pre- and postconditioning Br. J. Anaesth., August 1, 2005; 95(2): 140 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. De Hert, F. Turani, S. Mathur, and D. F. Stowe Cardioprotection with Volatile Anesthetics: Mechanisms and Clinical Implications Anesth. Analg., June 1, 2005; 100(6): 1584 - 1593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Garcia, K. Julier, L. Bestmann, A. Zollinger, L. K. von Segesser, T. Pasch, D. R. Spahn, and M. Zaugg Preconditioning with sevoflurane decreases PECAM-1 expression and improves one-year cardiovascular outcome in coronary artery bypass graft surgery Br. J. Anaesth., February 1, 2005; 94(2): 159 - 165. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Shi, W. C. Hutchins, J. Su, D. Siker, N. Hogg, K. A. Pritchard Jr., A. Keszler, J. S. Tweddell, and J. E. Baker Delayed cardioprotection with isoflurane: role of reactive oxygen and nitrogen Am J Physiol Heart Circ Physiol, January 1, 2005; 288(1): H175 - H184. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Yang, S. M. Harrison, and D. S. Steele ATP-dependent effects of halothane on SR Ca2+ regulation in permeabilized atrial myocytes Cardiovasc Res, January 1, 2005; 65(1): 167 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. da Silva, E. Lucchinetti, T. Pasch, M. C. Schaub, and M. Zaugg Ischemic but not pharmacological preconditioning elicits a gene expression profile similar to unprotected myocardium Physiol Genomics, December 15, 2004; 20(1): 117 - 130. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Magner and D. Royston Heart failure Br. J. Anaesth., July 1, 2004; 93(1): 74 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Zaugg, M. C. Schaub, and P. Foex Myocardial injury and its prevention in the perioperative setting Br. J. Anaesth., July 1, 2004; 93(1): 21 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Riess, D. F. Stowe, and D. C. Warltier Cardiac pharmacological preconditioning with volatile anesthetics: from bench to bedside? Am J Physiol Heart Circ Physiol, May 1, 2004; 286(5): H1603 - H1607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R. Spahn and H.-J. Priebe Editorial II: Preoperative hypertension: remain wary? 'Yes'--cancel surgery? 'No' Br. J. Anaesth., April 1, 2004; 92(4): 461 - 464. [Full Text] [PDF]
|
|
|
|
|
|
M. Zaugg, E. Lucchinetti, C. Garcia, T. Pasch, D. R. Spahn, and M. C. Schaub Anaesthetics and cardiac preconditioning. Part II. Clinical implications Br. J. Anaesth., October 1, 2003; 91(4): 566 - 576. [Abstract] [Full Text] [PDF]
|
|