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CARDIOVASCULAR ANESTHESIA

The Direct Myocardial Effects of Xenon in the Dog Heart In Vivo

Benedikt Preckel, MD DEAA^*, Dirk Ebel, MD, Jost Müllenheim, MD^*, Jan Fräßdorf, MD^*, Volker Thämer, MD, and Wolfgang Schlack, MD DEAA^*

Klinik für *Anaesthesiologie and Physiologisches Institut I Universitätsklinikum Düsseldorf, Germany

Address correspondence and reprint requests to Benedikt Preckel, MD, DEAA, Klinik für Anaesthesiologie Universitätsklinikum Düsseldorf, Postfach 10 10 07, D-40001 Düsseldorf, Germany. Address e-mail to preckel{at}uni-duesseldorf.de

Xenon has minimal hemodynamic side effects, but no data are available on its direct myocardial effects in vivo. We examined myocardial function during the global and regional administration of xenon in the dog heart. Anesthetized (midazolam/piritramide) dogs (n = 8) were instrumented for measurement of left ventricular pressure, cardiac output, and blood flow in the left anterior descending coronary artery (LAD) and circumflex coronary artery. Regional myocardial function was assessed by sonomicrometry in the antero-apical and the postero-basal wall. Hemodynamics were recorded during baseline conditions and during inhalation of 50% or 70% xenon, respectively. Subsequently, a bypass containing a membrane oxygenator was installed from the carotid artery to the LAD, allowing xenon administration only to the LAD-dependent myocardium. No changes in myocardial function were observed during inhalation of xenon. The regional administration of 50% xenon had no significant effect on regional myocardial function (systolic wall thickening and mean velocity of systolic wall thickening). Seventy percent xenon reduced systolic wall thickening by 7.2% ± 4.0% and mean velocity of systolic wall thickening by 8.2% ± 4.0% in the LAD-perfused area (P < 0.05). There were no changes of global hemodynamics, coronary blood flow, and regional myocardial function in the circumflex coronary artery-dependent myocardium. Xenon produces a small but consistent direct negative inotropic effect in vivo.

IMPLICATIONS: Regional administration of xenon direct to the left anterior descending-perfused myocardium resulted in a small but consistent negative inotropic effect of the noble gas in the dog heart in vivo.

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