Hannon James D, Cody Mark J
Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Anesthesiology. 2002 Jun;96(6):1457-64. doi: 10.1097/00000542-200206000-00027.
The surface membrane Ca(2+)-adenosine triphosphatase and Na(+)-Ca(2+) exchanger transport Ca(2+) out of the ventricular myocyte, competing for cytosolic Ca(2+) with the Ca(2+)-adenosine triphosphatase located in the sarcoplasmic reticulum. In this study the authors examined the effects of halothane, isoflurane, and sevoflurane on Ca(2+) extrusion from the cell and sarcoplasmic reticulum Ca(2+) content.
Single myocytes from the right ventricular free wall of adult male ferret hearts were isolated, loaded with the acetoxymethyl ester of the fluorescent Ca(2+) indicator fluo-3, and electrically stimulated at 0.25 Hz to reach a steady state level of intracellular Ca(2+) stores. The effects of halothane, isoflurane, and sevoflurane (1 minimum alveolar concentration) on the peak and rate of decline of the Ca(2+) transient induced by 10 mm caffeine were examined. The peak was used as an index of sarcoplasmic reticulum Ca(2+) content, and the rate of decline was used to monitor Ca(2+) extrusion from the cell.
During control conditions, halothane reduced the Ca(2+) content of the sarcoplasmic reticulum, isoflurane maintained it, and sevoflurane caused it to increase. Halothane did not affect Ca(2+) extrusion from the cell, but both isoflurane and sevoflurane inhibited it. When Na(+)-Ca(2+) exchange was inhibited by ionic substitution, isoflurane and sevoflurane still reduced the rate of Ca(2+) efflux from the cell. However, when the sarcolemmal Ca(2+)-adenosine triphosphatase was inhibited by carboxyeosin, isoflurane and sevoflurane had no effect on Ca(2+) efflux.
These results suggest that isoflurane and sevoflurane inhibit Ca(2+) transport from the cell via the sarcolemmal Ca(2+)-adenosine triphosphatase. This effect seems to counteract the decrease in Ca(2+) influx through sarcolemmal L-type Ca(2+) channels and maintains sarcoplasmic reticulum Ca(2+) stores.
细胞膜钙 - 腺苷三磷酸酶和钠 - 钙交换体将钙离子转运出心室肌细胞,与肌浆网中的钙 - 腺苷三磷酸酶竞争胞质钙离子。在本研究中,作者检测了氟烷、异氟烷和七氟烷对细胞钙离子外排及肌浆网钙离子含量的影响。
从成年雄性雪貂心脏右心室游离壁分离单个心肌细胞,用荧光钙指示剂氟罗 - 3的乙酰氧甲酯加载细胞,并以0.25赫兹频率进行电刺激,使细胞内钙离子储存达到稳态水平。检测氟烷、异氟烷和七氟烷(1个最低肺泡浓度)对10毫摩尔咖啡因诱导的钙离子瞬变峰值及下降速率的影响。峰值用作肌浆网钙离子含量的指标,下降速率用于监测细胞钙离子外排。
在对照条件下,氟烷降低肌浆网钙离子含量,异氟烷使其保持不变,七氟烷使其增加。氟烷不影响细胞钙离子外排,但异氟烷和七氟烷均抑制细胞钙离子外排。当通过离子置换抑制钠 - 钙交换时,异氟烷和七氟烷仍降低细胞钙离子外流速率。然而,当用羧基曙红抑制肌膜钙 - 腺苷三磷酸酶时,异氟烷和七氟烷对钙离子外流无影响。
这些结果表明,异氟烷和七氟烷通过肌膜钙 - 腺苷三磷酸酶抑制钙离子从细胞内转运。这种作用似乎抵消了通过肌膜L型钙通道钙离子内流的减少,并维持肌浆网钙离子储存。