Project

Back to overview

The effects of remifentanil, sevoflurane, isoflurane, and desfluance on diastolic function in humans

English title The effects of remifentanil, sevoflurane, isoflurane, and desfluance on diastolic function in humans
Applicant Seeberger Manfred
Number 116229
Funding scheme Project funding (Div. I-III)
Research institution Departement Anästhesie Universitätsspital Basel
Institution of higher education University of Basel - BS
Main discipline Clinical Cardiovascular Research
Start/End 01.04.2007 - 31.03.2010
Approved amount 168'750.00
Show all

Lay Summary (English)

Lead
Lay summary
Up to 40 % of patients with clinical symptoms of congestive heart failure have normal systolic left ventricular function but compromised diastolic function. Although heart failure is an important cause of perioperative morbidity, little information is available on the effect of anaesthetics on diastolic function. Many anaesthetics including the inhalational anaesthetics alter calcium homeostasis at several subcellular targets, e.g, the re-uptake of calcium into the sarcoplasmic reticulum. Dissociation of calcium from troponin C and active re-uptake of calcium into the sarcoplasmic reticulum during diastole are key processes of myosin detachment from actin, causing myocardial relaxation. The effects of anaesthetics on calcium homeostasis are regarded as the molecular basis for alterations of diastolic and systolic functions caused by anaesthetics. However, data on the effect of inhalational anaesthetics on left ventricular diastolic function are contradictory: whereas several laboratory and animal studies found an impairment of diastolic function caused by inhalational anaesthetics, our previous study on the effects of halothane and sevoflurane in healthy humans showed only an impairment of late diastole (i.e., atrial contraction) but no effect on early diastole, i.e., left ventricular relaxation and early filling. Data on the effect of remifentanil on left ventricular function in humans are lacking. Accordingly, the aim of this study is to examine the effects of the currently used inhalational anaesthetics sevoflurane, isoflurane, and desflurane, and of remifentanil on diastolic left ventricular function in healthy young subjects free from cardiovascular disease (Part I), and in patients with impaired diastolic but preserved systolic function (Part II). Doppler echocardiography is used for examination of the diastolic function at predefined steady-state conditions at baseline before induction of anaesthesia, during anaesthesia in the spontaneously breathing patient, and in the mechanically ventilated patient. This study of applied physiology and pharmacology will add information on the effect of anaesthetics on left ventricular diastolic function in vivo and might provide important data for evidence-based selection of anaesthetics, especially in patients with preexisting diastolic dysfunction.
Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

-