The Effects of Propofol on Cardiac Function After 4 Hours of Cold Cardioplegia and Reperfusion

Objective: To examine whether propofol protects against postischemic myocardial dysfunction and apoptosis during reperfusion after prolonged cold ischemia in isolated rat hearts.Design: A prospective, randomized, controlled study.Setting: A university laboratory.Participants: Animals.Interventions: The isolated hearts of 40 Sprague-Dawley male rats were perfused with modified Krebs-Hennseleit solution for 15 minutes for a stabilization period and 15 minutes for a perfusion period and then underwent 4 hours of global cold ischemia followed by 60 minutes of reperfusion. Four groups were studied (n = 10 for each group). Ten hearts served as an untreated control group. Propofol (2 μmol/L) treatment was performed only before ischemia in the PRE group, only during reperfusion in the POST group, and both before and after ischemia in the ALL group.Measurements and Main Results: Infusion of propofol during reperfusion improved recovery of left ventricular–developed pressure (LVDP) from 61.2% ± 8.5% (control) to 86.3% ± 12.1% (POST) and 74.9% ± 13.2% (ALL, both p < 0.05), whereas preischemic infusion of propofol (64.3% ± 9.7%, PRE) did not improve recovery of LVDP. Infusion of propofol during reperfusion significantly reduced the number of apoptotic cells and led to a smaller infarct size than control and PRE groups (p < 0.05, respectively).Conclusions: Propofol infusion during the reperfusion period produced a cardioprotective effect and inhibited apoptosis of cardiomyocytes in the ischemia-reperfusion model, with prolonged cold ischemia, in isolated rat hearts.