José Eduardo Tanus dos Santos

Increased Activities of Cardiac Matrix Metalloproteinases Matrix Metalloproteinase (MMP)-2 and MMP-9 Are Associated with Mortality during the Acute Phase of Experimental Trypanosoma cruzi Infection

The strong inflammatory reaction that occurs in the heart during the acute phase of Trypanosoma cruzi infection is modulated by cytokines and chemokines produced by leukocytes and cardiomyocytes. Matrix metalloproteinases (MMPs) have recently emerged as modulators of cardiovascular inflammation. In the present study we investigated the role of MMP-2 and MMP-9 in T. cruzi-induced myocarditis, by use of immunohistochemical analysis, gelatin zymography, enzyme-linked immunosorbent assay, and real-time polymerase chain reaction to analyze the cardiac tissues of T. cruzi-infected C57BL/6 mice. Increased transcripts levels, immunoreactivity, and enzymatic activity for MMP-2 and MMP-9 were observed by day 14 after infection. Mice treated with an MMP inhibitor showed significantly decreased heart inflammation, delayed peak in parasitemia, and improved survival rates, compared with the control group. Reduced levels of cardiac tumor necrosis factor-alpha, interferon-gamma, serum nitrite, and serum nitrate were also observed in the treated group. These results suggest an important role for MMPs in the induction of T. cruzi-induced acute myocarditis.

Propofol Suppresses Premature Atrial Contractions During Anesthesia

Hermann and Vettermann [3] administered propofol anesthesia to a child who had severe supraventricular tachycardia. The dysrhythmia converted to normal sinus rhythm a few seconds after the induction of the anesthesia. The rhythm converted back to supraventricular tachycardia 25 minutes after tracheal extubation. It was suggested that propofol may be an appropriate drug for patients with supraventricular tachycardia. We found that propofol produced similar effects in a boy scheduled for an inguinal hernia repair who presented with multiple atrial premature beats.

Efeitos hemodinâmicos da oclusão da aorta durante anestesia inalatória com isoflurano e sevoflurano: estudo experimental em cães

BACKGROUND AND OBJECTIVES Aortic flow suppression and release during aortic procedures promote major hemodynamic disorders. This study aimed at evaluating these disorders in dogs anesthetized with isoflurane or sevoflurane. METHODS This study involved 41 dogs divided in two groups according to the anesthetic agent used for maintenance with 1 MAC: GI (n = 21) isoflurane; GS (n = 20) sevoflurane. Aorta was occluded by intra-arterial infra-diafragmatic cuff inflation for 30 minutes. Hemodynamic parameters were observed in moments M1 (control), M2 and M3, 15 and 30 minutes after aortic occlusion, M4 and M5, 15 and 30 minutes after cuff deflation. RESULTS During aortic occlusion there has been increased mean blood pressure (MBP), central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP) and systemic vascular resistance (SVR), without increase in pulmonary vascular resistance (PVR) and cardiac output (CO). CO was more stable with isoflurane as compared to sevoflurane where it has decreased after occlusion. Heart rate has initially decreased followed by increase during occlusion, being more expressive in GS as compared to GI, however without statistically significant difference between groups. Systolic volume was not importantly changed; left and right ventricular function have similarly increased after occlusion for both groups. With flow release, MBP, CVP, PAP, PCWP and SVR have decreased, and PVR has increased for both groups; ventricular function has abruptly decreased. CONCLUSIONS This study has shown that isoflurane is a better indication for such interventions for promoting less hemodynamic changes.JUSTIFICATIVA Y OBJETIVOS: La supresion del flujo aortico y su posterior liberacion en intervenciones quirurgicas de la aorta, ocasionan importantes disturbios hemodinamicos. El objetivo de este estudio fue el de evaluar esas alteraciones en perros anestesiados con isoflurano o sevoflurano. METODO: Se estudiaron 41 perros, divididos en dos grupos segun el anestesico empleado en el mantenimiento con 1 CAM: GI (n = 21) isoflurano; GS (n = 20) sevoflurano. Se realizo la oclusion aortica por insuflacion de globo intraarterial infradiafragmatico por 30 minutos. Los parametros hemodinamicos fueron observados en los momentos M1 (control), M2 y M3, 15 y 30 minutos despues de la oclusion aortica, M4 y M5, 15 y 30 minutos despues de la desinsuflacion del globo. RESULTADOS: Durante la oclusion de la aorta, se observo el aumento de la presion arterial promedio (PAM), de la presion venosa central (PVC), de la presion de arteria pulmonar (PAP), de la presion de capilar pulmonar (PCP) y de la resistencia vascular sistemica (RVS) sin aumento de la resistencia vascular pulmonar (RVP) y del debito cardiaco (DC). El DC se mantuvo mas estable con el isoflurano comparado al sevoflurano, con el cual presento disminucion despues de la oclusion. La frecuencia cardiaca tuvo disminucion inicial que despues aumento durante la oclusion, siendo en GS mas expresiva que en GI, sin embargo, sin diferencia significativa entre los grupos. El volumen sistolico no tuvo grandes alteraciones; el trabajo sistolico de los ventriculos izquierdo y derecho aumento despues de la oclusion de forma similar en los dos grupos. Con la liberacion del flujo PAM, PVC, PAP, PCP y RVS bajaron, la RVP aumento en los dos grupos; el trabajo ventricular disminuye abruptamente. CONCLUSIONES: El estudio demostro que el isoflurano es el mas indicado en esas intervenciones quirurgicas por causar menores alteraciones hemodinamicas.

Efectos hemodinámicos de la oclusión de la aorta durante anestesia por inhalación con isoflurano y sevoflurano: estudio experimental en perros

BACKGROUND AND OBJECTIVES Aortic flow suppression and release during aortic procedures promote major hemodynamic disorders. This study aimed at evaluating these disorders in dogs anesthetized with isoflurane or sevoflurane. METHODS This study involved 41 dogs divided in two groups according to the anesthetic agent used for maintenance with 1 MAC: GI (n = 21) isoflurane; GS (n = 20) sevoflurane. Aorta was occluded by intra-arterial infra-diafragmatic cuff inflation for 30 minutes. Hemodynamic parameters were observed in moments M1 (control), M2 and M3, 15 and 30 minutes after aortic occlusion, M4 and M5, 15 and 30 minutes after cuff deflation. RESULTS During aortic occlusion there has been increased mean blood pressure (MBP), central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP) and systemic vascular resistance (SVR), without increase in pulmonary vascular resistance (PVR) and cardiac output (CO). CO was more stable with isoflurane as compared to sevoflurane where it has decreased after occlusion. Heart rate has initially decreased followed by increase during occlusion, being more expressive in GS as compared to GI, however without statistically significant difference between groups. Systolic volume was not importantly changed; left and right ventricular function have similarly increased after occlusion for both groups. With flow release, MBP, CVP, PAP, PCWP and SVR have decreased, and PVR has increased for both groups; ventricular function has abruptly decreased. CONCLUSIONS This study has shown that isoflurane is a better indication for such interventions for promoting less hemodynamic changes.JUSTIFICATIVA Y OBJETIVOS: La supresion del flujo aortico y su posterior liberacion en intervenciones quirurgicas de la aorta, ocasionan importantes disturbios hemodinamicos. El objetivo de este estudio fue el de evaluar esas alteraciones en perros anestesiados con isoflurano o sevoflurano. METODO: Se estudiaron 41 perros, divididos en dos grupos segun el anestesico empleado en el mantenimiento con 1 CAM: GI (n = 21) isoflurano; GS (n = 20) sevoflurano. Se realizo la oclusion aortica por insuflacion de globo intraarterial infradiafragmatico por 30 minutos. Los parametros hemodinamicos fueron observados en los momentos M1 (control), M2 y M3, 15 y 30 minutos despues de la oclusion aortica, M4 y M5, 15 y 30 minutos despues de la desinsuflacion del globo. RESULTADOS: Durante la oclusion de la aorta, se observo el aumento de la presion arterial promedio (PAM), de la presion venosa central (PVC), de la presion de arteria pulmonar (PAP), de la presion de capilar pulmonar (PCP) y de la resistencia vascular sistemica (RVS) sin aumento de la resistencia vascular pulmonar (RVP) y del debito cardiaco (DC). El DC se mantuvo mas estable con el isoflurano comparado al sevoflurano, con el cual presento disminucion despues de la oclusion. La frecuencia cardiaca tuvo disminucion inicial que despues aumento durante la oclusion, siendo en GS mas expresiva que en GI, sin embargo, sin diferencia significativa entre los grupos. El volumen sistolico no tuvo grandes alteraciones; el trabajo sistolico de los ventriculos izquierdo y derecho aumento despues de la oclusion de forma similar en los dos grupos. Con la liberacion del flujo PAM, PVC, PAP, PCP y RVS bajaron, la RVP aumento en los dos grupos; el trabajo ventricular disminuye abruptamente. CONCLUSIONES: El estudio demostro que el isoflurano es el mas indicado en esas intervenciones quirurgicas por causar menores alteraciones hemodinamicas.

[Hemodynamic effects of aortic occlusion during inhalational anesthesia with isoflurane and sevoflurane: experimental study in dogs].

BACKGROUND AND OBJECTIVES Aortic flow suppression and release during aortic procedures promote major hemodynamic disorders. This study aimed at evaluating these disorders in dogs anesthetized with isoflurane or sevoflurane. METHODS This study involved 41 dogs divided in two groups according to the anesthetic agent used for maintenance with 1 MAC: GI (n = 21) isoflurane; GS (n = 20) sevoflurane. Aorta was occluded by intra-arterial infra-diafragmatic cuff inflation for 30 minutes. Hemodynamic parameters were observed in moments M1 (control), M2 and M3, 15 and 30 minutes after aortic occlusion, M4 and M5, 15 and 30 minutes after cuff deflation. RESULTS During aortic occlusion there has been increased mean blood pressure (MBP), central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP) and systemic vascular resistance (SVR), without increase in pulmonary vascular resistance (PVR) and cardiac output (CO). CO was more stable with isoflurane as compared to sevoflurane where it has decreased after occlusion. Heart rate has initially decreased followed by increase during occlusion, being more expressive in GS as compared to GI, however without statistically significant difference between groups. Systolic volume was not importantly changed; left and right ventricular function have similarly increased after occlusion for both groups. With flow release, MBP, CVP, PAP, PCWP and SVR have decreased, and PVR has increased for both groups; ventricular function has abruptly decreased. CONCLUSIONS This study has shown that isoflurane is a better indication for such interventions for promoting less hemodynamic changes.JUSTIFICATIVA Y OBJETIVOS: La supresion del flujo aortico y su posterior liberacion en intervenciones quirurgicas de la aorta, ocasionan importantes disturbios hemodinamicos. El objetivo de este estudio fue el de evaluar esas alteraciones en perros anestesiados con isoflurano o sevoflurano. METODO: Se estudiaron 41 perros, divididos en dos grupos segun el anestesico empleado en el mantenimiento con 1 CAM: GI (n = 21) isoflurano; GS (n = 20) sevoflurano. Se realizo la oclusion aortica por insuflacion de globo intraarterial infradiafragmatico por 30 minutos. Los parametros hemodinamicos fueron observados en los momentos M1 (control), M2 y M3, 15 y 30 minutos despues de la oclusion aortica, M4 y M5, 15 y 30 minutos despues de la desinsuflacion del globo. RESULTADOS: Durante la oclusion de la aorta, se observo el aumento de la presion arterial promedio (PAM), de la presion venosa central (PVC), de la presion de arteria pulmonar (PAP), de la presion de capilar pulmonar (PCP) y de la resistencia vascular sistemica (RVS) sin aumento de la resistencia vascular pulmonar (RVP) y del debito cardiaco (DC). El DC se mantuvo mas estable con el isoflurano comparado al sevoflurano, con el cual presento disminucion despues de la oclusion. La frecuencia cardiaca tuvo disminucion inicial que despues aumento durante la oclusion, siendo en GS mas expresiva que en GI, sin embargo, sin diferencia significativa entre los grupos. El volumen sistolico no tuvo grandes alteraciones; el trabajo sistolico de los ventriculos izquierdo y derecho aumento despues de la oclusion de forma similar en los dos grupos. Con la liberacion del flujo PAM, PVC, PAP, PCP y RVS bajaron, la RVP aumento en los dos grupos; el trabajo ventricular disminuye abruptamente. CONCLUSIONES: El estudio demostro que el isoflurano es el mas indicado en esas intervenciones quirurgicas por causar menores alteraciones hemodinamicas.