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Mediators of Inflammation
Volume 2015 (2015), Article ID 819232, 12 pages
Research Article

Captopril Pretreatment Produces an Additive Cardioprotection to Isoflurane Preconditioning in Attenuating Myocardial Ischemia Reperfusion Injury in Rabbits and in Humans

1Department of Anesthesiology, Haikou Municipal Hospital, Affiliated Haikou Hospital Xiangya School of Medicine, Central South University, Haikou 570208, China
2Department of Anesthesiology, The University of Hong Kong, Hong Kong
3Department of Anesthesiology, Hainan Municipal Corps Hospital, Chinese People’s Armed Police Force, Haikou 570203, China
4Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
5Department of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524023, China

Received 23 November 2014; Accepted 27 December 2014

Academic Editor: Huang-Ping Yu

Copyright © 2015 Yi Tian et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Pretreatment with the angiotensin-converting inhibitor captopril or volatile anesthetic isoflurane has, respectively, been shown to attenuate myocardial ischemia reperfusion (MI/R) injury in rodents and in patients. It is unknown whether or not captopril pretreatment and isoflurane preconditioning (Iso) may additively or synergistically attenuate MI/R injury. Methods and Results. Patients selected for heart valve replacement surgery were randomly assigned to five groups: untreated control (Control), captopril pretreatment for 3 days (Cap3d), or single dose captopril (Cap1hr, 1 hour) before surgery with or without Iso (Cap3d+Iso and Cap1hr+Iso). Rabbit MI/R model was induced by occluding coronary artery for 30 min followed by 2-hour reperfusion. Rabbits were randomized to receive sham operation (Sham), MI/R (I/R), captopril (Cap, 24 hours before MI/R), Iso, or the combination of captopril and Iso (Iso+Cap). In patients, Cap3d+Iso but not Cap1hr+Iso additively reduced postischemic myocardial injury and attenuated postischemic myocardial inflammation. In rabbits, Cap or Iso significantly reduced postischemic myocardial infarction. Iso+Cap additively reduced cellular injury that was associated with improved postischemic myocardial functional recovery and reduced myocardial apoptosis and attenuated oxidative stress. Conclusion. A joint use of 3-day captopril treatment and isoflurane preconditioning additively attenuated MI/R by reducing oxidative stress and inflammation.