Guenoun T, Montagne O, Laplace M, Crozatier B
Unité Institut National de la Sante et de la Recherche Medicale (INSERM) U400, Faculté de Médecine, Créteil, France.
Anesthesiology. 2000 Feb;92(2):542-9. doi: 10.1097/00000542-200002000-00038.
Propofol is considered to be an anesthetic agent with few or no negative inotropic effects. This study evaluated a possible direct depressant effect of propofol on sarcoplasmic reticulum Ca2+ accumulation and cardiomyocytes.
The effects of propofol on intracellular Ca2+ transients were evaluated in isolated rat cardiomyocytes using a microfluorometric technique with Indo-1. Sarcoplasmic reticulum function was also assessed by measuring the oxalate-stimulated Ca2+ uptake from homogenates of rat ventricles.
The Ca2+ uptake capacity of the sarcoplasmic reticulum was decreased by propofol (10(-4) M). Large concentrations of propofol decreased the rate of decrease of the intracellular Ca2+ transient, which resulted in an increase of diastolic Ca2+ when the diastolic interval was decreased. The increased diastolic Ca2+ also resulted in a decrease in Ca2+ transient. This effect appeared for lower doses (10(-5) M) after a short diastolic pause rather than after a long (2- to 3-min) rest (appearing at 10(-4) M).
For doses more than 10(-5) M, propofol induces a Ca2+ uptake capacity impairment of the sarcoplasmic reticulum. This is probably responsible for a slowing of the decrease of the Ca2+ transient, which in turn increases the diastolic Ca2+ for high heart rate. These diastolic modifications may participate in the slight negative inotropic effect of the drug.
丙泊酚被认为是一种几乎没有或没有负性肌力作用的麻醉剂。本研究评估了丙泊酚对肌浆网Ca2+蓄积和心肌细胞可能的直接抑制作用。
采用 Indo-1 微荧光技术在离体大鼠心肌细胞中评估丙泊酚对细胞内Ca2+瞬变的影响。还通过测量草酸盐刺激的大鼠心室匀浆Ca2+摄取来评估肌浆网功能。
丙泊酚(10(-4) M)降低了肌浆网的Ca2+摄取能力。高浓度丙泊酚降低了细胞内Ca2+瞬变的下降速率,当舒张间期缩短时导致舒张期Ca2+增加。舒张期Ca2+增加也导致Ca2+瞬变减少。这种效应在短舒张期停顿后较低剂量(10(-5) M)时出现,而不是在长(2至3分钟)休息后(在10(-4) M时出现)。
对于超过10(-5) M的剂量,丙泊酚会导致肌浆网Ca2+摄取能力受损。这可能是Ca2+瞬变下降减慢的原因,进而在高心率时增加舒张期Ca2+。这些舒张期改变可能参与了该药物轻微的负性肌力作用。