Effects of Propofol on Left Ventricular Mechanoenergetics in the Excised Cross-circulated Canine Heart
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Although propofol is commonly used for general anesthesia, its direct effects on left ventricular (LV) contractility and energetics remain unknown. Accordingly, we studied the effects of intracoronary propofol on excised cross-circulated canine hearts using the framework of the Emax (a contractility index)-PVA (systolic pressure-volume area, a measure of total mechanical energy)-Vo2 (myocardial oxygen consumption per beat) relationship. We obtained 1) the Vo2-PVA relationship of isovolumic contractions with varied LV volumes at a constant Emax, 2) the Vo2-PVA relationship with varied LV volumes at a constant intracoronary concentration of propofol, and 3) the Vo2-PVA relationship under increased intracoronary concentrations of either propofol or CaCl2 at a constant LV volume to assess the cardiac mechanoenergetic effects of propofol. We found that propofol decreased Emax dose-dependently. The slope of the linear Vo2-PVA relationship (oxygen cost of PVA) remained unchanged by propofol. The PVA-independent Vo2-Emax relationship (oxygen cost of Emax) was the same for propofol and Ca2＋. In conclusion, propofol showed a direct negative inotropic effect on LV. At its clinical concentrations, decreases in contractility by propofol were relatively small. Propofol shows mechanoenergetic effects on the LV that are similar to those of Ca2＋ blockers or ß-antagonists—i.e., it exerts negative inotropic effects without changing the oxygen costs of Emax and PVA.
- Acta Medica Okayama
Acta Medica Okayama 66(6), 435-442, 2012-12
Okayama University Medical School