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Education  |   December 2000
Myocardial Protection and Oxyhemoglobin Dissociation Curve
Author Notes
  • The following correspondence refers to a previously published Clinical Concepts and Commentary article by Warltier et al. (Warltier DC, Pagel PS, Kersten JR: Approaches to the prevention of perioperative myocardial ischemia. Anesthesiology 2000; 92:253–9).
  • Sarasota Memorial Hospital, Sarasota, Florida. barrydoc@gte.net
Article Information
Education
Education   |   December 2000
Myocardial Protection and Oxyhemoglobin Dissociation Curve
Anesthesiology 12 2000, Vol.93, 1531. doi:
Anesthesiology 12 2000, Vol.93, 1531. doi:
To the Editor:—
In an excellent review of myocardial protection during anesthesia, Warltier et al.  1 mention the possibility of improving oxygen availability to the myocardium by a right shift of the oxyhemoglobin dissociation curve. 2–4 The beneficial effects of β-blocking drugs also are reviewed. However, the correlation of the well-known fact that β-blockers shift the curve to the right is omitted. This rightward shift may promote oxygen delivery to the myocardium during ischemia. The clear reduction in perioperative infarction rates after β-blockade rests on this fundamental effect.
References
Warltier DC, Pagel PS, Kersten JR: Approaches to the prevention of myocardial ischemia. Anesthesiology 2000; 92: 253–9Warltier, DC Pagel, PS Kersten, JR
Korkusho OV, Pisaruk AV, Lasitsa TS: Mechanisms of the effect of propranolol on the oxygen transport function of blood in elderly patients with ischemic heart disease. Kardiologia 1986; 26: 54–8Korkusho, OV Pisaruk, AV Lasitsa, TS
Giunta R: Effect of propranolol on the oxyhemoglobin dissociation curve. Farmaco Pratico 1983; 38: 456–62Giunta, R
Cross GJ: Effect of propranolol and nitroglycerin on the oxyhemoglobin affinity. Eur J Pharmacol 1976; 36: 267–71Cross, GJ