alexa The Anesthetic Propofol For Cardioprotection In Diabetes: An Update
ISSN: 2155-6156

Journal of Diabetes & Metabolism
Open Access

Like us on:
OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Share This Page

Additional Info

Loading
Loading Please wait..
 

5th World Congress on Diabetes & Metabolism
November 03-05, 2014 Embassy Suites Las Vegas, USA

Xu Jinjin
ScientificTracks Abstracts: J Diabetes Metab
DOI: 10.4172/2155-6156.S1.026
Abstract
Diabetes mellitus is the fifth leading cause of death worldwide. Diabetic patients often die from diabetic complications, the majority of which are connected with cardiovascular disease. Following Surgery, patients with diabetes suffer higher rates of perioperative cardiovascular morbidity, mortality, and a lower rate of survival than non-diabetic patients. Anesthetics may change the mode of ventricular filling and often modify and attenuate the stabilization of cardiac hemodynamics during surgery in patients. Increase in oxidative stress under pathological conditions has been shown to make the heart more prone to insults. In diabetes, hyperglycemia increases reactive oxygen species (ROS) production and induces oxidative stress, which has been recognized as a major mechanism of myocardial injury. Thus, cardiovascular responses to anesthesia in diabetic patients can be less predictable, making these patients more susceptible to cardiovascular complications during surgery which may be in part as a consequence of increased oxidative stress, and impaired endogenous myocardial protective pathway. Increasing evidence shows that propofol, a commonly used general anesthetic with antioxidant potential, can confer cardioprotection in patients undergoing either cardiac or non-cardiac surgery. However, the cardioprotective effects of propofol in patients with diabetes are debatable. Although conventional low doses of propofol have not been clinically effective in reducing postoperative cardiac injury or improving cardiac function, our in vivo study suggest that high doses of propofol can improve cardiac function and inhibit oxidative stress in diabetic rats. In line with our results, Crespo et al (Diab Vasc Dis Res. 2011 Oct;8(4):299-302) reported that propofol (50mg/kg IP) can increase cardiac output and systolic blood pressure (SBP), which should improve tissue perfusion in diabetic patients undergoing surgical procedures. Propofol is known to cause vasodilation by increasing nitric oxide (NO)-mediated relaxation secondary to eNOS activation. In diabetic rats, however, NO-mediated relaxation is impaired, and oxidative stress is increased. However, Wickley and colleagues suggest that propofol should be administered cautiously to diabetic patients with limited inotropic reserve and /or diastolic dysfunction because propofol can cause a decrease in myofilament Ca2+ sensitivity via protein kinase C and nitric oxide synthase-dependent pathway in diabetic cardiomyocytes, which may subsequently lead to hemodynamic instability. Therefore, it seems necessary that largescale randomized clinical trials in diabetic patients be performed in the near future in order to answer whether or not propofol can confer cardioprotection in diabetic patients.
image PDF   |   image HTML
 

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords