Study of effects and its mechanism of sevoflurane preconditioning on cardiovascular function of coronary heart patients

Abstract

Objective To investigate the effects of sevoflurane preconditioning on cardiovascular function in patients with coronary heart diseases, and explore its mechanism. Methods Eighty patients with coronary heart disease during 2009 January to 2012 December from our hospital patients were selected and randomly divided into the study group （41 cases） and control group （39 cases）. Patients in study group were given sevoflurane preconditioning, while the control group were given propofol. A series of parameters were recorded, including the patientg heart rate （ HR）, central venous pressure （ CVP）, mean arterial pressure （ MAP）, stroke volume （SV）, cardiac output （CO）, systolic time ratio （STR） and serum cardiac troponin T （cTnT） before induction of anesthesia （ T0 ）, 30min （ T1） during the operation, incision suture （ T2 ）, 6h after operation （ T3 ）, 12h after operation （ T4 ）, and 24 h after operation （T5 ）. Results HR, CO, SV, CVP, MAP, STR, and cTnT of the research group were relatively more stable than the control group in the preoperative, intraoperative, postoperative, and recovery. The study group at CO, T1 , SV, STR, and cTnT were （3.48 ±0. 40 ） L/min, （ 6. 4±1.9 ） ml/（ min ·m^2 ）, （ 0. 36±0. 76 ）, （ 0. 227±0. 112 ） ng/ml, CO, SV, STR in T2 and cTnT were （ 3.58±0. 52） L/min, （6. 6 ±2. 3） ml/（min ·m^2）, （0. 36±0. 63）, （0. 241±0. 115） ng/ml, control group T1 at CO, SV, STR and cTnT were （3. 11±0. 53）L/min, （5.2±2. 1）ml/（min·m^2） , （0.46±0. 81）, （0. 351±0. 106） ng/ml, CO, SV, STR in T2 and cTnT were （3. 15±0.61）L/min, （5.7±1.5）ml/（min . m2）, （0.44±0.90）, （0.311±0. 112） ng/ml. The patients in study group were in T1 CO, SV CO in T1 , SV, T2 times higher than that in control group. STR in T1 , T2 point was lower than that of the control group, cTnT in T1 , T2 point was lower than that of the control group, and the difference between the groups was statistically significant （ P〈0. 05）. Research group of patients with CO, SV higher than that in control group at in T1 ,T2, and STR lower than that at T1 ,T2, cTnT lower than that of the control group at in T1 , T2, and the differences were statistically significant （ P〈0. 05 ）. Conclusions Sevoflurane preconditioning can make the hemodynamics more stable, more suitable for clinical anesthesia, and its mechanism may be related to the changes of cardiac troponin T. Key words: Methyl ethers/pharmacology;  Anesthetics, inhalation/pharmacology;  Coronary disease ;  Troponin T