Abstract
Background: Enflurane and isoflurane may reduce cardiac contractility by altering mobilization and clearance of intracellular Ca2+ (Ca2+(i)). It was hypothesized that the negative inotropic actions of these agents involve limiting both membrane Ca2+ entry and altering intracellular Ca2+ release. Methods: The Ca2+(i) transients in rat ventricular myocytes loaded with fura-2 were recorded from a fluorescence microscope. Transients stimulated by membrane depolarization (suction electrode or elevated [K+](o)) or 15 mM caffeine to release Ca2+ from the sarcoplasmic reticulum (SR) were analyzed for net amplitude, maximal rate of rise (V(R)), average rate of decline (V(R)) in [Ca2+](i), and duration. Results: Enflurane and isoflurane reduced electrically stimulated Ca2+(i) transients in a dose- dependent manner. Enflurane depressed the Ca2+(i) transient amplitude more than isoflurane. Enflurane was more effective than isoflurane in reducing V(R) and V(F) in a concentration-dependent manner. At similar concentrations, both enflurane and isoflurane reduced the steady state elevation of [Ca2+](i) by 50 mM K+(o). Similarly, enflurane and isoflurane depressed caffeine-sensitive release of Ca2+ from the SR. The reduction in the Ca2+(i) transient because of SR Ca2+ release was greater in enflurane than in equal concentrations of isoflurane. Rates of elevation and decline in [Ca2+](i) were also reduced in enflurane and isoflurane. Conclusions: The negative inotropic actions of enflurane and isoflurane involve a depression of Ca2+ influx during membrane excitation, as well as a reduction in SR Ca2+ release. Slowed rates of elevation in [Ca2+](i) indicate that the latter mechanism may, in part, be caused by alterations in the kinetics of SR Ca2+ release.
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Wilde, D. W., Davidson, B. A., Smith, M. D., & Knight, P. R. (1993). Effects of isoflurane and enflurane on intracellular Ca2+ mobilization in isolated cardiac myocytes. Anesthesiology, 79(1), 73–82. https://doi.org/10.1097/00000542-199307000-00012
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