- Poster presentation
- Open Access
Early treatment with isoflurane improves cardiac function and increases survival in a rat model of TAKO-TSUBO cardiomyopathy
© Oras et al.; 2015
- Published: 1 October 2015
- Heart Failure
- Left Ventricle
- Cardiac Function
- Early Institution
Tako-tsubo cardiomyopathy (TCM) is an acute cardiac syndrome with severe hypokinesia of the left ventricle (LV), often affecting the apex causing apical ballooning and heart failure. Sympathetic stress is a trigger of TCM and is probably underdiagnosed and not uncommon in ICU patients . We have developed an experimental rat model of TCM, in which LV apical akinesia develops after intraperitoneal (i.p.) injection of isoprenaline with many similarities to clinical TCM . We recently demonstrated that pre-treatment with isoflurane could prevent the development of LV apical akinesia in this TCM animal model .
In the present study, we examined whether isoflurane, when used for treatment, could attenuate the degree of LV dysfunction and reduce mortality in a TCM animal model.
TCM was induced in seventy-five propofol sedated animals by intraperitonial injection of isoprenaline (50 mg/kg). Within 90 minutes after injection, the animals develop tako-tsubo-like heart failure with apical dyskinesia/akinesia and reduced cardiac output . The animals were randomized to either inhalation with no isoflurane (CONTROL, n=15) or inhalation with 1% isoflurane before (ISOFL 0, n=15), 10 min (ISOFL 10, n=15), 30 min (ISOFL 30, n=15) and 120 min (ISOFL 120, n=15) after induction of TCM. Evaluation of cardiac function with echocardiography was performed 90 minutes after isoprenaline in all animals. Extent of apical akinesia was expressed as percentage of LV endocardial length that was akinetic. After the experimental procedure, the animals were monitored for 48 hours for assessment of survival.
In this animal model of TCM, isoflurane treatment, when started early after induction of TCM, highly attenuated degree of LV apical akinesia. This was accompanied by a clearly improvement of survival. Isoflurane sedation in the ICU could be a beneficial strategy in patients suffering from hyper-adrenergic conditions.
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