Anesthesia and Cardiovascular Disease - Anesthesia and Cardiovascular Disease

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Advances in Pharmacology: Anesthesia and Cardiovascular Disease

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Contents

Contributors

Preface

Part I: Cardiac Muscle

Chapter 1. Regulation of the Calcium Slow Channels of Heart by Cyclic Nucleotides and Effects of Ischemia

I. Introduction

II. Types of Calcium Channels

III. Cyclic AMP Stimulation of Slow Calcium Channels

IV. Phosphorylation Hypothesis

V. Protein Kinase A Stimulation

VI. Cyclic GMP Inhibition of Slow Calcium Current

VII. Protein Kinase G Inhibition

VIII. Inhibition by Muscarinic Agonists

IX. Protein Kinase C and Calmodulin Protein Kinase

X. Comparison with Vascular Smooth Muscle and Skeletal Muscle

XI. Direct Stimulation of Slow Calcium Channels by Gs Proteins and ß-Receptors

XII. Summary

References

Chapter 2. Functional Adaptation to Myocardial Ischemia: Interaction with Volatile Anesthetics in Chronically Instrumented Dogs

I. Introduction

II. Chronic Instrumentation and Monitoring

III. Effects of Ischemic Preconditioning on Functional Recovery from Stunning in Conscious Dogs

IV. Discussion

References

Chapter 3. Excitation–Contraction Uncoupling and Vasodilators for Long-Term Cold Preservation of Isolated Hearts

I. Introduction

II. Long-Term Cardiac Perfusion

III. Preservation of Isolated Hearts

IV. Discussion

References

Chapter 4. Troponin T as a Marker of Perioperative Myocardial Cell Damage

I. Introduction

II. Cardiac Troponin

III. Troponin T in Coronary Artery Bypass Patients with Unstable Angina

IV. Troponin T versus Conventional Markers of Myocardial Cell Damage in Perioperative Settings

V. Summary

References

Chapter 5. Silent Myocardial Ischemia: Pathophysiology and Perioperative Management

I. Introduction

II. Pathophysiology of Silent Myocardial Ischemia

III. Detection of Silent Myocardial Ischemia

IV. Which Laboratory Methods Should Be Used for Screening Purposes?

V. Perioperative Medical Management of Silent Myocardial Ischemia

VI. Summary

References

Chapter 6. Effect of Halothane on Sarcolemmal Calcium Channels during Myocardial Ischemia and Reperfusion

I. Introduction

II. Canine Model for Myocardial Ischemia and Reperfusion

III. Isolation of Sarcolemma-Enriched Preparation

IV. Binding Capacity of Isradipine

V. Summary

References

Chapter 7. Myocardial Ischemic Preconditioning

I. Introduction

II. Myocardial Ischemia

III. Effects on Infarct Size

IV. Discussion

References

Chapter 8. Effects of Hypoxia/Reoxygenation on Intracellular Calcium Ion Homeostasis in Ventricular Myocytes during Halothane Exposure

I. Introduction

II. Intracellular Calcium Measurements

III. Effects of Hypoxia, with or without Halothane, on Myocyte Morphology

IV. Effects of Hypoxia, with or without Halothane, on Intracellular Calcium

V. Effects of Hypoxia, with or without Halothane, on Electrically Induced Calcium Transients

VI. Effects of Hypoxia, with or without Halothane, on Caffeine-Induced Calcium Transients

VII. Discussion

References

Chapter 9. Mechanical Consequences of Calcium Channel Modulation during Volatile Anesthetic-Induced Left Ventricular Systolic and Diastolic Dysfunction

I. Introduction

II. Materials and Methods

III. Effects of Anesthetics and Calcium Channel Modulation

IV. Discussion

References

Chapter 10. Anesthetic Actions on Calcium Uptake and Calcium-Dependent Adenosine Triphosphatase Activity of Cardiac Sarcoplasmic Reticulum

I. Introduction

II. Sarcoplasmic Reticulum

III. Calcium Uptake and ATPase Activity

IV. Discussion

References

Chapter 11. Interaction of Anesthetics and Catecholamines on Conduction in the Canine His–Purkinje System

I. Introduction

II. Catecholamine–Anesthetic Interaction

III. Summary

References

Chapter 12. Anesthetics, Catecholamines, and Ouabain on Automaticity of Primary and Secondary Pacemakers

I. Introduction

II. Isolated and Chronic Atrial Preparations

III. Anesthetic Interactions with Ouabain and Catecholamines

IV. Discussion

V. Conclusions

VI. Future Directions

References

Chapter 13. The Role of L-Type Voltage-Dependent Calcium Channels in Anesthetic Depression of Contractility

I. Introduction

II. Isolated Heart Preparation

III. Effects of Anesthetics on Isradipine Binding

IV. Discussion

References

Chapter 14. Effects of Inhibition of Transsarcolemmal Calcium Influx on Content and Releasability of Calcium Stored in Sarcoplasmic Reticulum of Intact Myocardium

I. Introduction

II. Isolated Papillary Muscle Preparation

III. Calcium Influx and Release

IV. Discussion

References

Chapter 15. Arrhythmogenic Effect of Inhalation Anesthetics: Biochemical Heterogeneity between Conduction and Contractile Systems and Protein Unfolding

I. Introduction

II. Cyclic AMP and the Conduction System

III. Myocardial Sensitizing Agents and Phosphodiesterase

IV. Mode of Anesthetic–Protein Interaction

V. Unfolding of Proteins

VI. Specific Binding: Lack of Definition

References

Part II: Coronary Circulation

Chapter 1. Potassium Channel Current and Coronary Vasodilatation by Volatile Anesthetics

I. Introduction

II. Isolated Vessel Ring Experiments

III. Patch Clamp Experiments

IV. Effects of Anesthetics on Isolated Coronary Vessels

V. Effects of Anesthetics on Whole-Cell Potassium Current

VI. Effects of Anesthetics on Single Potassium Channel Current

VII. Discussion

References

Chapter 2. Potassium Channel Opening and Coronary Vasodilation by Halothane

I. Introduction

II. Isolated Coronary Vessel Preparation

III. Effects of Endothelin

IV. Effects of Methacholine

V. Effects of Potassium

VI. Discussion

References

Chapter 3. Volatile Anesthetics and Coronary Collateral Circulation

I. Introduction

II. Chronic Animal Instrumentation

III. Regional Myocardial Function and Perfusion

IV. Coronary Steal Prone Anatomy Model

V. Hemodynamic Effects of' Isoflurane, Sevoflurane, and Adenosine

VI. Regional Myocardial Perfusion: Isoflurane, Sevoflurane, and Adenosine

VII. Discussion

References

Chapter 4. Myocardial Oxygen Supply–Demand Relations during Isovolemic Hemodilution

I. Introduction

II. Experimental Studies

III. Summary

References

Part III: Cellular Targets

Chapter 1. Plasma Membrane Ca2+-ATPase as a Target for Volatile Anesthetics

I. Introduction

II. Isolation and Activity Assay of Ca2+-ATPase

III. Effects of Anesthetics

IV. Discussion

References

Chapter 2. Enhancement of Halothane Action at the Ryanodine Receptor by Unsaturated Fatty Acids

I. Introduction

II. Calcium Efflux

III. Calcium Release from Heavy Sarcoplasmic Reticulum Fraction

IV. Discussion

References

Chapter 3. Adrenergic Receptors: Unique Localization in Human Tissues

I. Introduction

II. Methods Used to Study Receptor Distribution

III. Localization of Receptors in Human Tissue

IV. Summary

References

Chapter 4. Volatile Anesthetic Effects on Inositol Triphosphate-Gated Intracellular Calcium Stores in GH3 Cells

I. Introduction

II. Intracellular Calcium Measurements

III. Effects of Anesthetics

IV. Summary

References

Part IV: Reflex Regulation

Chapter 1. Differential Control of Blood Pressure by Two Subtypes of Carotid Baroreceptors

I. Introduction

II. Carotid Baroreceptors

III. Carotid Sinus Nerve Activity

IV. Discussion

V. Anesthetic Implications

References

Chapter 2. Sympathetic Activation with Desflurane in Humans

I. Introduction

II. Sympathetic Microneurography

III. Anesthetics and Sympathetic Activation

IV. Discussion

V. Summary

References

Chapter 3. Randomized, Prospective Comparison of Halothane, Isoflurane, and Enflurane on Baroreflex Control of Heart Rate in Humans

I. Introduction

II. Baroreflex Function in Humans

III. Effects of Anesthetics

IV. Discussion

References

Chapter 4. Baroreflex Modulation by Isoflurane Anesthesia in Normotensive and Chronically Hypertensive Rabbits

I. Introduction

II. Chronically Hypertensive Rabbit Model and Experimental Protocol

III. Effect of Isoflurane on Arterial Pressure–Renal Sympathetic Nerve Activity and Arterial Pressure–Heart Rate Barocurves

IV. Discussion

References

Part V: Peripheral Circulation

Chapter 1. Effects of lsoflurane on Regulation of Capacitance Vessels under Normotensive and Chronically Hypertensive Conditions

I. Introduction

II. Hypertensive Rabbit Preparation

III. Mesenteric Reflex Measurements

IV. Circulatory Responses to Baroreflex and Chemoreflex Responses in Normotensive and Hypertensive Animals

V. Effects of Isoflurane on Hypoxia and Baroreflex- Mediated Responses

Vl. Effects of Isoflurane on Prestimulation Baseline Measurements

VII. Discussion

References

Chapter 2. Effect of Volatile Anesthetics on Baroreflex Control of Mesenteric Venous Capacitance

I. Introduction

II. Measurement of Venous Capacitance

III. Response to Baroreceptor Stimulaton

IV. Response to Electric Stimulation

V. Discussion

References

Chapter 3. Effect of General Anesthesia on Modulation of Sympathetic Nervous System Function

I. Introduction

II. Effect of Intravenous and Inhalational Anesthetics on Norepinephrine Kinetics

III. ß-Adrenergic Receptor-Mediated Release of Norepinephrine

IV. Effect of Inhalational Anesthesia on Prejunctional Norepinephrine Release in Viuo

V. Conclusions

References

Chapter 4. Inhibition of Nitric Oxide-Dependent Vasodilaton by Halogenated Anesthetics

I. Introduction

II. Methods

III. Effects of Anesthetics on Endotheliurn-Dependent Relaxations of Isolated Blood Vessels

IV. Effects of Halothane and Isoflurane on Nitric Oxide-, Nitroglycerin-, and Carbon Monoxide-Induced Relaxations of Rat Aorta

V. Effects of Halothane on Nitric Oxide-Stimulated Cyclic GMP

VI. Interactions of Halothane and Nitric Oxide in Absence of Tissues

VII. Discussion

References

Chapter 5. Effects of Epidural Anesthesia on Splanchnic Capacitance

I. Introduction

II. Epidural Anesthesia

III. Splanchnic Capacitance

IV. Summary

References

Chapter 6. Anesthetic Modulation of Pulmonary Vascular Regulation

I. Introduction

II. Measurement of Pulmonary Vasoregulation

III. Anesthesia and Pulmonary Vasoregulation

IV. Summary

References

Chapter 7. Pulmonary Mechanics Changes Associated with Cardiac Surgery

I. Introduction

II. Dynamic Lung Compliance

III. Effects of Sternotomy

IV. Discussion

References

Chapter 8. Inhaled Nitric Oxide in Adult Respiratory Distress Syndrome and Other Lung Diseases

I. Introduction

II. Pulmonary Hypertension in Adult Respiratory Distress Syndrome

III. Nitric Oxide

IV. Rationale for Use of Inhaled Nitric Oxide in Patients with Adult Respiratory Distress Syndrome

V. Laboratory Studies of Inhaled Nitric Oxide

VI. Clinical Studies of Nitric Oxide Inhalation in Adult Respiratory Distress Syndrome

VII. Inhaled Nitric Oxide in Other Lung Diseases Associated with Pulmonary Hypertension

VIII. Toxicity of Nitric Oxide

IX. Guidelines for Nitric Oxide Inhalation

References

Chapter 9. First Pass Uptake in the Human Lung of Drugs Used during Anesthesia

I. Introduction

II. First Pass Drug Uptake in Human Lung

III. Factors Affecting Pulmonary Drug Uptake

IV. Conclusions

References

Chapter 10. Lactic Acidosis and pH on the Cardiovascular System

I. Introduction

II. Induction of Lactic Acidosis

III. Cardiovascular Effects of Acute Acidosis

IV. Discussion

References

Part VI: CerebraI Circulation

Chapter 1. Role of Oxygen Free Radicals and Lipid Peroxidation in Cerebral Reperfusion Injury

I. Introduction

II. Free Radicals

III. Mechanisms of Brain Injury

IV. Potential Therapeutic Agents

V. Conclusion

References

Chapter 2. Effects of Volatile Anesthetics on Cerebrocortical Laser Doppler Flow: Hyperemia, Autoregulation, Carbon Dioxide Response, Flow Oscillations, and Role of Nitric Oxide

I. Introduction

II. Measurement of Laser Doppler Flow

III. Resting Flow

IV. Autoregulation

V. Hypocapnia and Hypercapnia

VI. Role of Nitric Oxide

VII. Spontaneous Flow Oscillations

VIII. Conclusions

References

Chapter 3. Cerebral Blood Flow during Isovolemic Hemodilution: Mechanistic Observations

I. Introduction

II. Influence of Hemodiluton on Cerebral Blood Volume

III. Influence of Focal Cortical Brain Lesion on Regional Cerebral Blood Flow Response to Hemodilution

IV. Comparison of Cerebrovascular and Metabolic Changes Produced by Hypoxia and Hemodilution

V. Role of Nitric Oxide in the Cerebral Blood Flow Response to Hemodilution

VI. Discussion

References

Chapter 4. Cerebral Physiology during Cardiopulmonary Bypass: Pulsatile versus Nonpulsatile Flow

I. Introduction

II. Pulsatile versus Nonpulsatile Bypass

III. Influence of Arterial Pressure Waveform

IV. Summary

References

Chapter 5. Anesthetic Actions of Cardiovascular Control Mechanisms in the Central Nervous System

I. Introduction

II. Studies Performed in Cats

III. Studies in Mongrel Dogs

IV. Central Nervous System Pressor Site Responses in Cats and Intermediolateral Cell Column Evoked Potential

V. Anesthetic Responses in Dogs

VI. Histological Documentation of Electrode Sites

VII. Discussion

References

Index

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