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Phosphodiesterase-III-inhibition with amrinone leads to contracture development in skeletal muscle preparations of malignant hyperthermia susceptible swine

Published online by Cambridge University Press:  29 April 2005

M. Fiege ,
F. Wappler ,
R. Weisshorn ,
M. U. Gerbershagen ,
K. Kolodzie  and
J. Schulte am Esch
M. Fiege
Affiliation:
University-Hospital Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany
F. Wappler
Affiliation:
University-Hospital Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany
R. Weisshorn
Affiliation:
University-Hospital Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany
M. U. Gerbershagen
Affiliation:
University-Hospital Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany
K. Kolodzie
Affiliation:
University-Hospital Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany
J. Schulte am Esch
Affiliation:
University-Hospital Hamburg-Eppendorf, Department of Anaesthesiology, Hamburg, Germany
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Abstract

Summary

Background and objective: The phosphodiesterase-III (PDE-III) inhibitor enoximone-induced marked contractures in skeletal muscle specimens of malignant hyperthermia (MH) susceptible (MHS) human beings and swine. Whether this is a substance specific effect of enoximone or caused by inhibition of PDE-III remained unclear. Therefore, the effects of the PDE-III inhibitor amrinone in porcine MH normal (MHN) and MHS skeletal muscles were investigated.

Methods: MH-trigger-free general anaesthesia was performed in eight MHS and eight MHN swine. The MH status of the swine was determined by detection of the Arg615–Cys point mutation on chromosome 6 indicating MH susceptibility. Skeletal muscle specimens were excised for the in vitro contracture tests with amrinone. Amrinone was added cumulatively every 5 min to muscle specimens in order to obtain organ bath concentrations between 20 and 400 μmol L−1. The in vitro effects of amrinone on muscle contractures and twitches were measured.

Results: Amrinone-induced contractures in all skeletal muscle preparations. MHS muscles developed contractures at significantly lower bath concentrations of amrinone than MHN muscles. Contractures of MHS compared to MHN muscles were significantly larger at bath concentrations of 80, 100, 150, 200 and 400 μmol L−1 amrinone. Muscle twitches remained unchanged up to and including 200 μmol L−1 amrinone.

Conclusions: Inhibition of PDE-III in general elicited higher contractures in MHS than in MHN muscles. Therefore, a contribution of PDE-III and the cyclic adenosine monophosphate (cAMP) system in the pathophysiology of MH must be suspected.

Keywords

MALIGNANT HYPERTHERMIA, diagnosis, pathophysiologyPHOSPHODIESTERASE INHIBITORS, amrinone, enoximone
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 4 , April 2005 , pp. 283 - 288
Copyright
2005 European Society of Anaesthesiology

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