The effects of propofol cardioplegia on blood and myocardial biomarkers of stress and injury in patients with isolated coronary artery bypass grafting or aortic valve replacement using cardiopulmonary bypass: Protocol for a single-center randomized controlled trial

JMIR Research Protocols

Volumn 3, Issue 3, 2014, Pages

  Plummer, Zoe E ^a   Baos, Sarah ^a   Rogers, Chris A ^a   Suleiman, M Saadeh ^a   Bryan, Alan J ^b   Angelini, Gianni D ^b   Hillier, James ^b   Downes, Richard ^b   Nicholson, Eamonn ^b   Reeves, Barnaby C ^a  

^a UNIVERSITY OF BRISTOL   (United Kingdom)

^b UNIVERSITY HOSPITALS BRISTOL NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

Anesthetics; Aortic valve; Cardiac surgery; Cardioplegia; Cardiopulmonary bypass; Clinical trials, randomized; Coronary artery; Ischemia; Reperfusion; Troponin

Indexed keywords

EID: 85099716248     PISSN: None     EISSN: 19290748     Source Type: Journal    
DOI: 10.2196/resprot.3353     Document Type: Article

References (42)

1. Suleiman MS, Halestrap AP, Griffiths EJ. Mitochondria: A target for myocardial protection. Pharmacol Ther 2001 Jan; 89(1):29-46. [Medline: 11316512]
2. Halestrap AP, Pasdois P. The role of the mitochondrial permeability transition pore in heart disease. Biochim Biophys Acta 2009 Nov; 1787(11):1402-1415 [FREE Full text] [doi: 10.1016/j.bbabio.2008.12.017] [Medline: 19168026]
3. Forde RC, Fitzgerald DJ. Reactive oxygen species and platelet activation in reperfusion injury. Circulation 1997 Feb 18; 95(4):787-789 [FREE Full text] [Medline: 9054729]
4. Halestrap AP, Kerr PM, Javadov S, Woodfield KY. Elucidating the molecular mechanism of the permeability transition pore and its role in reperfusion injury of the heart. Biochim Biophys Acta 1998 Aug 10; 1366(1-2):79-94. [Medline: 9714750]
5. Ascione R, Caputo M, Gomes WJ, Lotto AA, Bryan AJ, Angelini GD, et al. Myocardial injury in hypertrophic hearts of patients undergoing aortic valve surgery using cold or warm blood cardioplegia. Eur J Cardiothorac Surg 2002 Mar; 21(3):440-446. [Medline: 11888760]
6. Caputo M, Ascione R, Angelini GD, Suleiman MS, Bryan AJ. The end of the cold era: From intermittent cold to intermittent warm blood cardioplegia. Eur J Cardiothorac Surg 1998 Nov; 14(5):467-475. [Medline: 9860202]
7. Caputo M, Modi P, Imura H, Pawade A, Parry AJ, Suleiman MS, et al. Cold blood versus cold crystalloid cardioplegia for repair of ventricular septal defects in pediatric heart surgery: A randomized controlled trial. Ann Thorac Surg 2002 Aug; 74(2):530-4; discussion 535. [Medline: 12173840]
8. Demmy TL, Haggerty SP, Boley TM, Curtis JJ. Lack of cardioplegia uniformity in clinical myocardial preservation. Ann Thorac Surg 1994 Mar; 57(3):648-651. [Medline: 8147636]
9. Lotto AA, Ascione R, Caputo M, Bryan AJ, Angelini GD, Suleiman MS. Myocardial protection with intermittent cold blood during aortic valve operation: Antegrade versus retrograde delivery. Ann Thorac Surg 2003 Oct; 76(4):1227-33; discussion 1233. [Medline: 14530016]
10. Matsuda H, Levitsky S, McCully JD. Inhibition of RNA transcription modulates magnesium-supplemented potassium cardioplegia protection. Ann Thorac Surg 2000 Dec; 70(6):2107-2112. [Medline: 11156129]
11. Yamamoto H, Yamamoto F. Myocardial protection in cardiac surgery: A historical review from the beginning to the current topics. Gen Thorac Cardiovasc Surg 2013 Sep; 61(9):485-496. [doi: 10.1007/s11748-013-0279-4] [Medline: 23877427]
12. Kato R, Foex P. Myocardial protection by anesthetic agents against ischemia-reperfusion injury: An update for anesthesiologists. Can J Anaesth 2002 Oct; 49(8):777-791. [doi: 10.1007/BF03017409] [Medline: 12374705]
13. Kevin LG, Novalija E, Stowe DF. Reactive oxygen species as mediators of cardiac injury and protection: The relevance to anesthesia practice. Anesth Analg 2005 Nov; 101(5):1275-1287. [doi: 10.1213/01.ANE.0000180999.81013.D0] [Medline: 16243980]
14. Riess ML, Stowe DF, Warltier DC. Cardiac pharmacological preconditioning with volatile anesthetics: From bench to bedside? Am J Physiol Heart Circ Physiol 2004 May; 286(5):H1603-H1607 [FREE Full text] [doi: 10.1152/ajpheart.00963.2003] [Medline: 15072968]
15. De Hert SG, ten Broecke PW, Mertens E, Van Sommeren EW, De Blier IG, Stockman BA, et al. Sevoflurane but not propofol preserves myocardial function in coronary surgery patients. Anesthesiology 2002 Jul; 97(1):42-49 [FREE Full text] [Medline: 12131102]
16. Suleiman MS, Zacharowski K, Angelini GD. Inflammatory response and cardioprotection during open-heart surgery: The importance of anaesthetics. Br J Pharmacol 2008 Jan; 153(1):21-33 [FREE Full text] [doi: 10.1038/sj.bjp.0707526] [Medline: 17952108]
17. Kokita N, Hara A. Propofol attenuates hydrogen peroxide-induced mechanical and metabolic derangements in the isolated rat heart. Anesthesiology 1996 Jan; 84(1):117-127 [FREE Full text] [Medline: 8572324]
18. Kokita N, Hara A, Abiko Y, Arakawa J, Hashizume H, Namiki A. Propofol improves functional and metabolic recovery in ischemic reperfused isolated rat hearts. Anesth Analg 1998 Feb; 86(2):252-258. [Medline: 9459228]
19. Ko SH, Yu CW, Lee SK, Choe H, Chung MJ, Kwak YG, et al. Propofol attenuates ischemia-reperfusion injury in the isolated rat heart. Anesth Analg 1997 Oct; 85(4):719-724. [Medline: 9322445]
20. Buljubasic N, Marijic J, Berczi V, Supan DF, Kampine JP, Bosnjak ZJ. Differential effects of etomidate, propofol, and midazolam on calcium and potassium channel currents in canine myocardial cells. Anesthesiology 1996 Nov; 85(5):1092-1099 [FREE Full text] [Medline: 8916827]
21. Li YC, Ridefelt P, Wiklund L, Bjerneroth G. Propofol induces a lowering of free cytosolic calcium in myocardial cells. Acta Anaesthesiol Scand 1997 May; 41(5):633-638. [Medline: 9181167]
22. Eriksson O, Pollesello P, Saris NE. Inhibition of lipid peroxidation in isolated rat liver mitochondria by the general anaesthetic propofol. Biochem Pharmacol 1992 Jul 22; 44(2):391-393. [Medline: 1322668]
23. Murphy PG, Myers DS, Davies MJ, Webster NR, Jones JG. The antioxidant potential of propofol (2, 6-diisopropylphenol). Br J Anaesth 1992 Jun; 68(6):613-618. [Medline: 1319189]
24. Murphy PG, Bennett JR, Myers DS, Davies MJ, Jones JG. The effect of propofol anaesthesia on free radical-induced lipid peroxidation in rat liver microsomes. Eur J Anaesthesiol 1993 Jul; 10(4):261-266. [Medline: 8330595]
25. Green TR, Bennett SR, Nelson VM. Specificity and properties of propofol as an antioxidant free radical scavenger. Toxicol Appl Pharmacol 1994 Nov; 129(1):163-169. [doi: 10.1006/taap.1994.1240] [Medline: 7974491]
26. Xia Z, Godin DV, Ansley DM. Propofol enhances ischemic tolerance of middle-aged rat hearts: Effects on 15-F(2t)-isoprostane formation and tissue antioxidant capacity. Cardiovasc Res 2003 Jul 1; 59(1):113-121 [FREE Full text] [Medline: 12829182]
27. Xia Z, Godin DV, Chang TK, Ansley DM. Dose-dependent protection of cardiac function by propofol during ischemia and early reperfusion in rats: Effects on 15-F2t-isoprostane formation. Can J Physiol Pharmacol 2003 Jan; 81(1):14-21. [doi: 10.1139/y02-170] [Medline: 12665253]
28. Eriksson O. Effects of the general anaesthetic Propofol on the Ca2(+)-induced permeabilization of rat liver mitochondria. FEBS Lett 1991 Feb 11; 279(1):45-48 [FREE Full text] [Medline: 1704857]
29. Sztark F, Ichas F, Ouhabi R, Dabadie P, Mazat JP. Effects of the anaesthetic propofol on the calcium-induced permeability transition of rat heart mitochondria: Direct pore inhibition and shift of the gating potential. FEBS Lett 1995 Jul 10; 368(1):101-104 [FREE Full text] [Medline: 7615059]
30. Lim KH, Halestrap AP, Angelini GD, Suleiman MS. Propofol is cardioprotective in a clinically relevant model of normothermic blood cardioplegic arrest and cardiopulmonary bypass. Exp Biol Med (Maywood) 2005 Jun; 230(6):413-420. [Medline: 15956771]
31. Lou PH, Lucchinetti E, Zhang L, Affolter A, Schaub MC, Gandhi M, et al. The mechanism of IntralipidR-mediated cardioprotection complex IV inhibition by the active metabolite, palmitoylcarnitine, generates reactive oxygen species and activates reperfusion injury salvage kinases. PLoS One 2014; 9(1):e87205 [FREE Full text] [doi: 10.1371/journal.pone.0087205] [Medline: 24498043]
32. Javadov SA, Lim KH, Kerr PM, Suleiman MS, Angelini GD, Halestrap AP. Protection of hearts from reperfusion injury by propofol is associated with inhibition of the mitochondrial permeability transition. Cardiovasc Res 2000 Jan 14; 45(2):360-369 [FREE Full text] [Medline: 10728356]
33. Schroter S, Lamping DL. Coronary revascularisation outcome questionnaire (CROQ): Development and validation of a new, patient based measure of outcome in coronary bypass surgery and angioplasty. Heart 2004 Dec; 90(12):1460-1466 [FREE Full text] [doi: 10.1136/hrt.2003.021899] [Medline: 15547029]
34. Rector TS, Anand IS, Cohn JN. Relationships between clinical assessments and patients' perceptions of the effects of heart failure on their quality of life. J Card Fail 2006 Mar; 12(2):87-92. [doi: 10.1016/j.cardfail.2005.10.002] [Medline: 16520254]
35. Cohen J. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: L Erlbaum Associates; 1988.
36. Moher D, Schulz KF, Altman DG, CONSORT Group. The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomised trials. Clin Oral Investig 2003 Mar; 7(1):2-7. [doi: 10.1007/s00784-002-0188-x] [Medline: 12673431]
37. Sayin MM, Ozatamer O, Ta oz R, Kilinc K, Unal N. Propofol attenuates myocardial lipid peroxidation during coronary artery bypass grafting surgery. Br J Anaesth 2002 Aug; 89(2):242-246 [FREE Full text] [Medline: 12378660]
38. Bein B, Renner J, Caliebe D, Scholz J, Paris A, Fraund S, et al. Sevoflurane but not propofol preserves myocardial function during minimally invasive direct coronary artery bypass surgery. Anesth Analg 2005 Mar; 100(3):610-6, table of contents. [doi: 10.1213/01.ANE.0000145012.27484.A7] [Medline: 15728039]
39. Ansley DM, Sun J, Visser WA, Dolman J, Godin DV, Garnett ME, et al. High dose propofol enhances red cell antioxidant capacity during CPB in humans. Can J Anaesth 1999 Jul; 46(7):641-648. [doi: 10.1007/BF03013951] [Medline: 10442958]
40. Xia Z, Huang Z, Ansley DM. Large-dose propofol during cardiopulmonary bypass decreases biochemical markers of myocardial injury in coronary surgery patients: A comparison with isoflurane. Anesth Analg 2006 Sep; 103(3):527-532. [doi: 10.1213/01.ane.0000230612.29452.a6] [Medline: 16931656]
41. Cockshott ID. Propofol ('Diprivan') pharmacokinetics and metabolism-an overview. Postgrad Med J 1985; 61 Suppl 3:45-50. [Medline: 3903719]
42. Kanto J, Gepts E. Pharmacokinetic implications for the clinical use of propofol. Clin Pharmacokinet 1989 Nov; 17(5):308-326. [doi: 10.2165/00003088-198917050-00002] [Medline: 2684471]