The Effect of Anesthetics on Myocardial Adenine Nucleotides

  • R. G. Merin
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 91)

Abstract

The major interest in the effect of anesthetics on high-energy phosphates (adenine nucleotides) in the heart stems from the search for the mechanism of the negative inotropic effect of anesthetics and the interest in preserving myocardial energy during cardiac ischemia. Although the number of studies published is rather small, the results when the preparation has been stable are consistent. Anesthetics do not appear to change the concentration of high-energy phosphates in normal hearts. There is some evidence that barbiturates in high concentrations may interfere with myocardial energy synthesis and decrease high-energy phosphates in hypoxic or ischemic hearts and additional evidence that perhaps cardiac depressant anesthetics such as halothane may preserve high-energy phosphates in ischemic hearts. However, much more investigation is necessary in the ischemic heart in order to come to definite conclusions.

Keywords

Creatine Phosphate Negative Inotropic Effect Thoracic Epidural Anesthesia Total Ischemia Ischemic Contracture 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Bricknell OL, Daries PS, Opie LH: A relationship between adenosine triphosphate, glycolysis and ischemic contracture in the isolated rat heart. J Mol Cell Cardiol 13:941–945, 1981PubMedCrossRefGoogle Scholar
  2. 2.
    Cronau LH, Merin RG, De Jong JW: Effect of halothane on glucose utilization in the perfused working rat heart. J Cardiovasc Pharmacol, in press.Google Scholar
  3. 3.
    Doorey AJ, Barry WH: The efects of inhibition of oxidative phosphorylation and glycolysis on contractility and high energy phosphate content in cultured chick heart cells. Circ Res 53:192–201, 1983PubMedGoogle Scholar
  4. 4.
    Freedman B, Christian C, Ham D, Everson C, Wechsler A: Isoflurane and myocardial protection. Anesthesiology 59:A25, 1983 (Abstr)Google Scholar
  5. 5.
    Freedman BM, Ham D, Everson CT, Wechsler AS, Christian CM: Enflurance enhances postishemic functional recovery in the isolated rat heart. Anesthesiology 62:29–33, 1985PubMedCrossRefGoogle Scholar
  6. 6.
    Hearse DJ, Crome R, Yellon DM, Wyse R: Metabolic and flow correlates of myocardial ischemia. Cardiavasc Res 17:452–458, 1983CrossRefGoogle Scholar
  7. 7.
    Kashimoto S, Hinohara S, Tanaka Y, Kumazawa T: Effects of thiopental on cardiac energy metabolism in post-ischemic reperfusion in rat. J Anesth 1:77–81, 1987PubMedCrossRefGoogle Scholar
  8. 8.
    Kashimoto S, Tanaka Y, Manabe M, Kumazawa T: Comparison of hemodynamic and metabolic effects of fentanyl and morphine in isolated rat heart lung preparations. Hiroshima J Anesth 21:19–25, 1985Google Scholar
  9. 9.
    Kashimoto S, Tsuji Y, Kumazawa T: Effects of halothane and enflurane on myocardial metabolism during post-ischemic reperfusion in the rat. Acta Anaesth Scand 31:44–47, 1987PubMedCrossRefGoogle Scholar
  10. 10.
    Kashimoto S, Tsuji Y, Miyaji T, Kumazawa T: Effects of fentanyl and fentanyl-diazepam on myocardial metabolism in isolated rat heart lung preparation. Hiroshima J Anesth 22:297–304, 1986Google Scholar
  11. 11.
    McAuliffe JJ, Hickey PR: Effect of halothane on the steady state levels of high energy phosphates in the neonatal heart. Anesthesiology 67:231–235, 1987PubMedCrossRefGoogle Scholar
  12. 12.
    Merin RG: Inhalation anesthetics and myocardial metabolism: Possible mechanisms of functional effects. Anesthesiology 39:216–255, 1973PubMedCrossRefGoogle Scholar
  13. 13.
    Merin RG: Myocardial metabolism. In: Kaplan JA, ed: Cardiac anesthesia. Vol 2, Cardiovascular pharmacology. New York: Grune and Stratton, 1983:243–266Google Scholar
  14. 14.
    Merin RG, Verdouw, PD, De Jong JW: Dose-dependent depression of cardiac function and metabolism by halothane in swine. Anesthesiology 46:417–423, 1977PubMedCrossRefGoogle Scholar
  15. 15.
    Murray PA, Blanck TJJ, Rogers MC, Jacobus WE: Effects of halothane on myocardial high-energy phosphate metabolism and intracellular pH utilizing 31PNMR spectroscopy. Anesthesiology 67:649–653, 1987PubMedCrossRefGoogle Scholar
  16. 16.
    Peyton R, Christian C, Fargraeus L, van Trigt P, Spray T, Pellom G, Pasque M, Wechsler A: Halothane and myocardial protection. Anesthesiology 57:A9, 1982 (Abstr)CrossRefGoogle Scholar
  17. 17.
    Ruigrok TJC, Slade AM, Van der Meer P, De Moes D, Sinclair DM, Poole-Wilson PA, Meijler FL: Different effects of thiopental in severe hypoxia, total ischemia and low flow ischemia in rat heart muscle. Anesthesiology 63:172–178, 1985PubMedCrossRefGoogle Scholar
  18. 18.
    Rusy BF, Komai H: Anesthetic depression of myocardial contractility: A review of possible mechanisms. Anesthesiology 67:745–766, 1987PubMedCrossRefGoogle Scholar
  19. 19.
    Stong LJ, Hartzell CR, McCarl RL: Halothane and the beating response in ATP turnover rate of heart cells in tissue culture. Anesthesiology 42:123–132, 1975PubMedCrossRefGoogle Scholar
  20. 20.
    Taegtmeyer H: Six blind men explore an elephant: Aspects of fuel metabolism in the control of tricarboxylic acid cycle activity in heart muscle. Basic Res Cardiol 79:322–366, 1984PubMedCrossRefGoogle Scholar
  21. 21.
    Taegtmeyer H: Carbohydrate interconversions and energy production. Circulation 72, Suppl IV: 1–8, 1985Google Scholar
  22. 22.
    Tsuchida H: Experimental study on the effects of thoracic epidural anesthesia on myocardial pH decrease and metabolic change induced by acute coronary artery occlusion. Sapporo Med J 56:143–155, 1987Google Scholar
  23. 23.
    Weiss J, Hiltbrand B: Functional compartmentation of glycolytic versus oxidative metabolism in isolated rabbit heart. J Clin Invest 75:436–447, 1985PubMedCrossRefGoogle Scholar
  24. 24.
    Weiss JN, Lamp ST: Glycolysis preferentially inhibits ATP-sensitive K+ channels in isolated guinea pig cardiac myocytes. Science 238:67–70, 1987PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • R. G. Merin
    • 1
  1. 1.Department of AnesthesiologyUniversity of Texas Medical School at HoustonHoustonUSA

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