TY - JOUR
T1 - The inotropic and lusitropic effects of ketamine in isolated human atrial myocardium: The effect of adrenoceptor blockade
AU - Hanouz, Jean-Luc
AU - Persehaye, Emmanuel
AU - Zhu, Lan
AU - Lammens, Stéphane
AU - Lepage, Olivier
AU - Massetti, Massimo
AU - Babatasi, Gérard
AU - Khayat, André
AU - Bricard, Henri
AU - Gérard, Jean-Louis
PY - 2004
Y1 - 2004
N2 - We studied the direct myocardial effects of racemic ketamine, in the presence of α- and β-adrenoceptor blockade, on isolated human right atrial myocardium. Isometric force of contraction (FoC), its first derivative with time (+dF/dt), the contraction relaxation coupling parameter R2 = (+dF/dt) / (-dF/dt), and time to half relaxation (T1/2) were recorded before and after addition of 10-6, 10-5 and 10-4 M racemic ketamine alone and in the presence of α-adrenoceptor blockade (phentolamine 10-6 M) and β-adrenoceptor blockade (propranolol at 10-6 M). Ketamine had a moderate positive inotropic effect at 10-5 M (FoC, 104% ± 5% of baseline value; P = 0.03) and 10-4 M (FoC, 107% ± 11% of baseline value; P = 0.09). Racemic ketamine had a negative inotropic effect in the presence of propranolol (FoC, ketamine 10-6 M, 77% ± 11%; ketamine 10-5 M, 63% ± 16%; ketamine 10-4 M, 62% ± 17% of baseline; P < 0.001) but not phentolamine (FoC, ketamine at 10-6 M, 94% ± 6%; ketamine 10-5 M, 96% ± 5%; and ketamine 10-4 M, 98% ± 15% of baseline). Ketamine decreased T1/2 (ketamine 10-5 M, 94% ± 3% of baseline value; P < 0.001 and ketamine 10-4 M, 90% ± 9% of baseline value; P = 0.007) but did not modify R2. In human right atrial myocardium, racemic ketamine induced a moderate positive inotropic effect and hastened isometric relaxation. In the presence of β-adrenoceptor blockade it induced a direct negative inotropic effect.
AB - We studied the direct myocardial effects of racemic ketamine, in the presence of α- and β-adrenoceptor blockade, on isolated human right atrial myocardium. Isometric force of contraction (FoC), its first derivative with time (+dF/dt), the contraction relaxation coupling parameter R2 = (+dF/dt) / (-dF/dt), and time to half relaxation (T1/2) were recorded before and after addition of 10-6, 10-5 and 10-4 M racemic ketamine alone and in the presence of α-adrenoceptor blockade (phentolamine 10-6 M) and β-adrenoceptor blockade (propranolol at 10-6 M). Ketamine had a moderate positive inotropic effect at 10-5 M (FoC, 104% ± 5% of baseline value; P = 0.03) and 10-4 M (FoC, 107% ± 11% of baseline value; P = 0.09). Racemic ketamine had a negative inotropic effect in the presence of propranolol (FoC, ketamine 10-6 M, 77% ± 11%; ketamine 10-5 M, 63% ± 16%; ketamine 10-4 M, 62% ± 17% of baseline; P < 0.001) but not phentolamine (FoC, ketamine at 10-6 M, 94% ± 6%; ketamine 10-5 M, 96% ± 5%; and ketamine 10-4 M, 98% ± 15% of baseline). Ketamine decreased T1/2 (ketamine 10-5 M, 94% ± 3% of baseline value; P < 0.001 and ketamine 10-4 M, 90% ± 9% of baseline value; P = 0.007) but did not modify R2. In human right atrial myocardium, racemic ketamine induced a moderate positive inotropic effect and hastened isometric relaxation. In the presence of β-adrenoceptor blockade it induced a direct negative inotropic effect.
KW - Adrenergic Antagonists
KW - Adrenergic alpha-Antagonists
KW - Adrenergic beta-Antagonists
KW - Anesthesiology and Pain Medicine
KW - Anesthetics, Dissociative
KW - Cardiotonic Agents
KW - Heart
KW - Humans
KW - In Vitro Techniques
KW - Isometric Contraction
KW - Ketamine
KW - Muscle Relaxation
KW - Myocardial Contraction
KW - Phentolamine
KW - Propranolol
KW - Adrenergic Antagonists
KW - Adrenergic alpha-Antagonists
KW - Adrenergic beta-Antagonists
KW - Anesthesiology and Pain Medicine
KW - Anesthetics, Dissociative
KW - Cardiotonic Agents
KW - Heart
KW - Humans
KW - In Vitro Techniques
KW - Isometric Contraction
KW - Ketamine
KW - Muscle Relaxation
KW - Myocardial Contraction
KW - Phentolamine
KW - Propranolol
UR - http://hdl.handle.net/10807/103934
U2 - 10.1213/01.ANE.0000136466.85913.3C
DO - 10.1213/01.ANE.0000136466.85913.3C
M3 - Article
SN - 0003-2999
VL - 99
SP - 1689
EP - 1695
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
ER -