Vivien B, Hanouz J L, Gueugniaud P Y, Lecarpentier Y, Coriat P, Riou B
Department of Anesthesiology, CHU Pitié-Salpétrière, Paris, France.
Anesthesiology. 1998 Nov;89(5):1191-8. doi: 10.1097/00000542-199811000-00020.
The effects of desflurane on myocardial contraction and relaxation in diseased myocardium have not been completely understood.
The effects of desflurane (1.8 to 9.4 vol%) in left ventricular papillary muscles of healthy hamsters and those with genetically induced cardiomyopathy (strain BIO 14.6) were investigated in vitro (29 degrees C, pH 7.40, Ca2+ 2.5 mM; stimulation frequency, 3/min) under low (isotony) and high (isometry) load. Data are mean percentages of baseline +/- SD.
Desflurane induced no significant inotropic effect in healthy muscles (maximum unloaded shortening velocity and isometric active force at 9.4 vol%: 97 +/- 9% and 92 +/- 20%, respectively). In contrast, in cardiomyopathic muscles, desflurane induced a moderate negative inotropic effect (maximum unloaded shortening velocity and active force at 9.4 vol%: 84 +/- 19% and 75 +/- 25%, respectively). The negative inotropic effect was more pronounced than that in healthy muscles under low (P < 0.05) but not high load, and even when concentrations were corrected for minimum alveolar concentrations in each strain. Adrenoceptor blockade or pretreatment with reserpine did not modify the inotropic effect of desflurane, suggesting the absence of intramyocardial catecholamine release. However, tyramine also did not induce any significant catecholamine release in hamster myocardium. In both strains, desflurane induced no significant lusitropic effect under low or high load.
Desflurane had no inotropic effect in healthy muscles and a moderate negative inotropic effect in cardiomyopathic muscles. The absence of desflurane-induced intramyocardial catecholamine release was related to hamster myocardium characteristics.
地氟醚对病变心肌收缩和舒张的影响尚未完全明确。
在体外（29℃，pH 7.40，Ca2+ 2.5 mM；刺激频率，3次/分钟）低（等张）和高（等长）负荷条件下，研究了地氟醚（1.8至9.4体积%）对健康仓鼠和基因诱导性心肌病（BIO 14.6品系）仓鼠左心室乳头肌的影响。数据为基线的平均百分比±标准差。
地氟醚对健康肌肉无显著的正性肌力作用（9.4体积%时最大无负荷缩短速度和等长主动力分别为97±9%和92±20%）。相比之下，在心肌病肌肉中，地氟醚诱导了中度负性肌力作用（9.4体积%时最大无负荷缩短速度和主动力分别为84±19%和75±25%）。在低负荷（P<0.05）而非高负荷下，负性肌力作用比健康肌肉更明显，即使浓度根据各品系的最低肺泡浓度进行了校正。肾上腺素能受体阻断或利血平预处理并未改变地氟醚的肌力作用，提示心肌内儿茶酚胺未释放。然而，酪胺在仓鼠心肌中也未诱导任何显著的儿茶酚胺释放。在两个品系中，地氟醚在低负荷或高负荷下均未诱导显著的舒张期肌力作用。
地氟醚对健康肌肉无肌力作用，对心肌病肌肉有中度负性肌力作用。地氟醚未诱导心肌内儿茶酚胺释放与仓鼠心肌特性有关。
