Does Propofol Improve Postischemic Myocardial Dysfunction by Reducing the Postischemic Adhesion of Polymorphonuclear Neutrophils?

Lim, Choon Hak; Cho, Hun; Choi, Sung Uk; Lee, Hye Won; Lim, Hye Ja; Yoon, Suk Min; Chang, Seong Ho

Abstract

BACKGROUND: Adhesion of polymorphonuclear neutrophils (PMNs) to the coronary vascular endothelium is a crucial step in the development of postischemic myocardial injury. Propofol, a free radical scavenger has been demonstrated to provide cardioprotective effects by attenuating ischemia and reperfusion injury. The purpose of this study was to investigate whether propofol inhibits the postischemic coronary vascular adhesion of PMNs and results in a reduction of postischemic myocardial dysfunction in isolated guinea pig hearts.
METHODS
42 male guinea pigs were used in this study. Hearts were isolated and perfused with modified Krebs-Hanseleit solution. All isolated hearts were subjected in turn to stabilization for 10 min, perfusion for 15 min, global ischemia for 30 min and reperfusion for 60 min. The isolated hearts were then divided into 6 groups. Each group was subjected to different interventions as follow so. C group: No intervention was performed, except ischemia/reperfusion injury. PPF group: Propofol (4 microgram/ml) was infused from the start of perfusion to 5 min after the start of reperfusion. PMN group: PMNs were infused for 1 min on 2 minutes after reperfusion. P2PMN group: Propofol (2 microgram/ml) was infused from the start of perfusion to 5 min after the start of reperfusion, and PMNs were infused for 1 min on 2 minutes after reperfusion. P4PMN group: Propofol (4 microgram/ml) was infused from the start of perfusion to 5 min after the start of reperfusion, and PMNs were infused for 1 min on 2 minutes after reperfusion. IL-PMN group: Intralipid (0.4 mg/ml) was infused from the start of perfusion to 5 min after the start of reperfusion, and PMNs were infused for 1 min on 2 minutes after reperfusion. PMNs adhesion (%), left ventricular developed pressure (LVDP), dP/dt, heart rates and coronary flow were measured.
RESULTS
Propofol (2 microgram/ml, 4 microgram/ml) significantly reduced postischemic PMNs adhesion compared with that of the PMN group (54.0+/-8.0%, 50.0+/-5.0% vs 72.5+/-6.5% P <0.05 respectively) and prevented the deterioration of myocardial function seen after PMNs application (LVDP 74.5+/-7.3%, 60.3+/-4.5% vs 48.4+/-2.7% respectively).
CONCLUSIONS
These results show that propofol reduces the postischemic coronary vascular adhesion of PMNs and prevents postischemic myocardial dysfuncion.