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Am J Physiol Heart Circ Physiol 289: H2585-H2591, 2005. First published July 8, 2005; doi:10.1152/ajpheart.00400.2005
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Isoflurane induces second window of preconditioning through upregulation of inducible nitric oxide synthase in rat heart

Mayu Wakeno-Takahashi,1 Hajime Otani,2 Shinichi Nakao,1 Hiroji Imamura,2 and Koh Shingu1

1Departments of Anesthesiology and 2Cardiovascular Center, Kansai Medical University, Moriguchi City, Japan

Submitted 22 April 2005 ; accepted in final form 6 July 2005

The second window of preconditioning (SWOP) induced by inhalation of volatile anesthetics has been documented in the rat heart and is triggered by nitric oxide synthase (NOS), but involvement of NOS in the mediator phase of isoflurane-induced SWOP has not been demonstrated. We tested the hypothesis that isoflurane-induced SWOP is mediated through upregulation of inducible NOS (iNOS). Rats inhaled 0.75 minimum alveolar concentration (MAC) isoflurane, 1.5 MAC isoflurane, or O2 for 2 h. After 24, 48, 72, and 96 h, the isolated heart was perfused with buffer and subjected to 30 min of ischemia followed by 2 h of reperfusion. Inhalation of 0.75 and 1.5 MAC isoflurane significantly limited infarct size after ischemia-reperfusion 24–72 h after isoflurane inhalation. The maximum effect was obtained 48 h after inhalation of 1.5 MAC isoflurane. Postischemic left ventricular function was improved only 48 h after inhalation of 1.5 MAC isoflurane. iNOS expression and activity in the heart were increased 24–72 h after inhalation of 1.5 MAC isoflurane; this increase was less pronounced after inhalation of 0.75 MAC isoflurane. A selective iNOS inhibitor, 1400W (10 µM), abolished iNOS activation and cardioprotection induced 48 h after inhalation of 1.5 MAC isoflurane. These results suggest that isoflurane inhalation induces SWOP after 24–72 h through overexpression and activation of iNOS in the rat heart.

infarct; cardioprotection; volatile anesthetics; ischemic preconditioning


Address for reprint requests and other correspondence: H. Otani, Cardiovascular Center, Kansai Medical Univ., Moriguchi City 570-8507, Japan (e-mail: otanih{at}takii.kmu.ac.jp)




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