Attention has recently been paid to associations between peripheral arterial disease (PAD) and microRNAs (miRs), which regulate gene expression. Various miRs, including miR-15a/16, miR-21, miR-92a, miR-126, miR-143/145 and miR-221/222, are known to be involved in atherosclerosis, which is the main pathogenesis of PAD. Associations of miRs with major risk factors of PAD such as diabetes and smoking have also been shown. Blood levels of some miRs have been reported to be changed in patients with PAD, and miRs are therefore possible biomarkers for diagnosis of PAD and prediction of its risk in the future. Application of miRs that promote neovascularization and inhibit progression of ischemia to therapy for PAD is also expected.
Propofol suppresses both the sympathetic and parasympathetic nervous systems. There have been no clinical studies examining the infusion rate-related hemodynamic interaction between propofol and landiolol, an ultra-short-acting β 1- blocking agent. Twenty-four patients were divided into two groups. Patients in the P-1.25 group (n＝12) received intravenous (IV) propofol (1.25 mg / kg) over 1 min followed by continuous infusion of propofol at 5 mg / kg / h. Tracheal intubation was facilitated with IV rocuronium, and anesthesia was maintained with propofol at 5 mg / kg / h and 67% nitrogen in oxygen. Patients in the P-2.5 group (n＝12) received IV propofol (2.5 mg / kg) over 1 min followed by propofol at 10 mg / kg / h. All other protocols were identical to those in the P-1.25 group. Fifteen minutes after tracheal intubation, patients in both groups received IV landiolol at incremental infusion rates (40, 50, 60, 70, 80, 90, and 100 μ g / kg / min for 2 min at each dose). Changes in heart rate (HR) were greater in patients in the P-1.25 group than the P-2.5 group. The landiolol infusion at 40, 50, or 60 μg / kg / min caused HR changes of －6±4, －9±6, and －13±6 beats / min (bpm) in the P-1.25 group, while the HR in the P-2.5 group decreased by －1±3, －4±2, and －6±4 bpm (mean±SD, P＜0.05). When landiolol was infused at a rate of 90 μg / kg / min, HR decreased by more than 15 bpm in all patients in the P-1.25 group, but only 40% of patients in the P-2.5 group. We conclude that the HR response to IV landiolol is attenuated at higher propofol infusion rates.
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