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Isoflurane causes powerful second window of protection (SWOP) against myocardial stunning in the dog

Despite intensive investigation, the ability of isoflurane (ISO) to cause SWOP in the myocardium remains a matter of debate. We tested the hypothesis that inhalation of ISO can reduce extent of myocardial stunning produced by ischemia 24 hours later. The findings with ISO were compared to those with ischemic preconditioning (IPC) produced by a 10 min coronary artery occlusion (CAO). 8 mongrel dogs were chronically instrumented to measure wall thickening (WT) in the left ventricle. In group 1 (n=4), dogs inhaled 1 MAC (1.4 %) ISO for 60 min, after which time they were allowed to recover for 24 hrs and studied in the conscious state. A 10 min CAO was induced and the recovery of WT was monitored for 24 hrs. In group 2 (n=4), dogs underwent IPC, induced by a 10 min CAO; 24 hrs later they were subjected to another 10 min CAO. The recovery of WT following the initial occlusion served as control (CON) for the effects of both ISO and IPC. CAO caused akinesis in all groups. Three hours of reperfusion were required for complete recovery of WT in the ISO and IPC. At this time WT remained significantly depressed (−25±4%) in CON; between 12 and 24 hrs of reperfusion was required for complete recovery. We conclude that isoflurane has powerful SWOP effects against myocardial stunning and that this effect is comparable to ischemic preconditioning in the dog.