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CARDIOVASCULAR ANESTHESIA

Ethanol Enhances the Functional Recovery of Stunned Myocardium Independent of K_ATP Channels in Dogs

Eric R. Gross, MS*, Meir Gare, MD, Wolfgang G. Toller, MD§, Judy R. Kersten, MD*, David C. Warltier, MD, PhD*, and Paul S. Pagel, MD, PhD*

Departments of *Anesthesiology, Medicine (Division of Cardiovascular Diseases), and Pharmacology and Toxicology, the Medical College of Wisconsin; the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin; and the §Department of Anesthesiology, University of Graz, Graz, Austria

Address correspondence and reprint requests to Paul S. Pagel, MD, PhD, Medical College of Wisconsin, MEB-M4280, 8701 Watertown Plank Rd., Milwaukee, WI 53226. Address e-mail to pspagel @mcw.edu.

Chronic, intermittent exposure to small amounts of ethanol reduces myocardial infarct size in vivo. We tested the hypothesis that acute administration of ethanol enhances the functional recovery of stunned myocardium and that adenosine triphosphate-dependent potassium (K_ATP) channels mediate this beneficial effect. Barbiturate-anesthetized dogs were instrumented for measurement of aortic and left ventricular pressure, +dP/dt_max, and subendocardial segment shortening (%SS) and were subjected to five 5-min periods of coronary artery occlusion, each separated by 5 min of reperfusion followed by a 3-h final reperfusion. In four groups (n = 7 each), dogs received 0.9% saline or ethanol (0.25, 0.5, or 1.0 g/kg over 30 min) in a random manner before occlusions and reperfusions. In other groups (n = 7 each), dogs received the K_ATP channel antagonist glyburide (0.3 mg/kg, IV) 30 min before saline or ethanol (0.25 g/kg) was administered. Dogs receiving saline or glyburide alone demonstrated poor recovery of contractile function during reperfusion (%SS = 0.9% ± 2.0% and 1.6% ± 1.2% at 3 h, respectively). Recovery of %SS was enhanced in dogs receiving the 0.25- and 0.5-g/kg doses of ethanol (10.0% ± 1.8% and 8.6% ± 2.2% at 3 h, respectively) independent of alterations in hemodynamics or coronary collateral blood flow (radioactive microspheres). Glyburide did not affect improvement of recovery of stunned myocardium produced by ethanol (11.8% ± 2.2% at 3 h). The results indicate that ethanol enhances the functional recovery of stunned myocardium independent of K_ATP channels in vivo.

Implications: Small amounts of ethanol improve the functional recovery of postischemic, reperfused myocardium in barbiturate-anesthetized dogs. These beneficial effects are not related to adenosine triphosphate-dependent potassium channels.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999