Heart Failure after Cardiac Surgery: The Role of Halogenated Agents, Myocardial Conditioning and Oxidative Stress

Int J Mol Sci. 2022 Jan 25;23(3):1360. doi: 10.3390/ijms23031360.

Abstract

Heart disease requires a surgical approach sometimes. Cardiac-surgery patients develop heart failure associated with ischemia induced during extracorporeal circulation. This complication could be decreased with anesthetic drugs. The cardioprotective effects of halogenated agents are based on pre- and postconditioning (sevoflurane, desflurane, or isoflurane) compared to intravenous hypnotics (propofol). We tried to put light on the shadows walking through the line of the halogenated anesthetic drugs' effects in several enzymatic routes and oxidative stress, waiting for the final results of the ACDHUVV-16 clinical trial regarding the genetic modulation of this kind of drugs.

Keywords: ACDHUVV-16; halogenated; heart failure; postconditioning; preconditioning.

Publication types

  • Review

MeSH terms

  • Anesthetics, Inhalation / pharmacology
  • Cardiac Surgical Procedures / methods
  • Cardiac Surgical Procedures / mortality*
  • Cardiomyopathies / drug therapy
  • Cardiomyopathies / surgery
  • Cardiotonic Agents / pharmacology
  • Heart Failure / etiology*
  • Heart Failure / mortality
  • Humans
  • Hydrocarbons, Halogenated / pharmacology*
  • Isoflurane / pharmacology
  • Myocardium / pathology
  • Oxidative Stress / physiology
  • Propofol / pharmacology
  • Sevoflurane / pharmacology

Substances

  • Anesthetics, Inhalation
  • Cardiotonic Agents
  • Hydrocarbons, Halogenated
  • Sevoflurane
  • Isoflurane
  • Propofol