This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Benedict, P. E. Articles by Bolling, S. F. Search for Related Content PubMed PubMed Citation Articles by Benedict, P. E. Articles by Bolling, S. F. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB FENTANYL MORPHINE PENTAZOCINE Related Collections Animal models of human disease CV surgery: coronary artery disease Receptor pharmacology

(Circulation. 1999;100:II-357.)
© 1999 American Heart Association, Inc.

Myocardial Protection and Vascular Biology

Opiate Drugs and -Receptor–Mediated Myocardial Protection

Patrick E. Benedict, MD; Mary B. Benedict, MD; Tsung-Ping Su, PhD; Steven F. Bolling, MD

From the University of Michigan Health System (P.E.B., S.F.B.) and St. Joseph Mercy Hospital (M.B.B.), Ann Arbor, Mich; and the National Institutes of Health, Bethesda, Md (T.-P.S.).

Correspondence to Patrick E. Benedict, MD, Department of Anesthesiology, University of Michigan Health System, 1500 E. Medical Center Drive, 1G323 Box 0048, University Hospital, Ann Arbor, MI 48109-0048. E-mail pbenedic{at}umich.edu

Background—Hypothermic myocardial arrest is necessary to complete most cardiac surgery, which limits the success of such operations. Similarly, cold, inhospitable environments limit the survival of warm-blooded animals. Animals have successfully adapted to this challenge through hibernation. Hibernation is an energy-conserving state, now known to be governed by cyclical variation in endogenous opiate compounds. It may also be induced in nonhibernators via hibernating animal serum factors or -opiate peptides. Furthermore, hibernation-induction triggers extend organ preservation in many models. This study examined whether opiate drugs with an affinity for the -opiate receptor confer similar protection.

Methods and Results—Isolated hearts harvested from New Zealand White rabbits were treated with either cardioplegia alone or -opiate drugs (fentanyl, morphine, buprenorphine, pentazocine) followed by 2 hours of 34°C ischemia. Hearts were then reperfused, and functional and metabolic indices of treated groups were compared with untreated controls. Isovolumic developed pressure, coronary flow, and oxygen consumption were compared as a percent of preischemia versus 45 minutes after reflow. Developed pressure and oxygen consumption were better preserved in the morphine, buprenorphine, and pentazocine groups when compared with cardioplegia alone.

Conclusions—Drugs with -opiate activity confer myocardial protection, which is additive to cardioplegia. Use of -opiate drugs in this context may have important clinical implications.

Key Words: cardioplegia • cardiopulmonary bypass • drugs • hibernation • receptors

This article has been cited by other articles:

				H. H. Patel, A. Hsu, and G. J. Gross Attenuation of heat shock-induced cardioprotection by treatment with the opiate receptor antagonist naloxone Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2011 - H2017. [Abstract] [Full Text] [PDF]