{"id":"5f8fa609f50f","type":"article","url":"https://hartvaat.nl/2026/09/01/perioperatieve-opioiden-bij-hartfalen-lokale-cardiale-routes-en-klinische-risico/","title":"Perioperatieve opioiden bij hartfalen: lokale cardiale routes en klinische risico’s","title_en":"Cardiac Opioid System and Its Role in Heart Failure and Ischemia-Reperfusion Injury.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog","internist"],"tags":[],"journal":"Anesthesiology","doi":"10.1097/ALN.0000000000006139","source_url":"https://doi.org/10.1097/ALN.0000000000006139","authors":["Alexandra Lasch","Melih Özgür Celik","Carolin Torregroza","Ragnar Huhn","Michael Schäfer","Sascha Treskatsch"],"significance":4,"published":"2026-08-19","source_date":"2026-09-01","image":"https://hartvaat.nl/global/img/0155cc89a708.webp","kennis":["https://hartvaat.nl/kennis/hartfalen/diagnose-hartfalen-stappenplan/","https://hartvaat.nl/kennis/farmacologie/antiaritmica-farmacologie/"],"congress":"","summary_en":"This review outlines the local cardiac opioid system and its contrasting roles in heart failure versus ischemia-reperfusion injury. While preclinical models indicate cardioprotective effects during ischemia-reperfusion, clinical opioid administration in heart failure is associated with higher in-hospital mortality and increased ventilatory support. Clinicians should account for these hemodynamic and prognostic risks when selecting perioperative analgesia.","created":"2026-08-13T01:03:53Z","updated":"2026-08-13T01:03:54Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze review beschrijft de functie van het lokale cardiale opioidensysteem bij hartfalen en ischemie-reperfusie-injury. Preklinisch onderzoek suggereert cardioprotectie tijdens ischemie-reperfusie, terwijl klinisch opioidgebruik bij hartfalenpatiënten wordt geassocieerd met een hoger sterftecijfer en meer ventilatorondersteuning. Klinisch artsen dienen deze hemodynamische en prognostische effecten te overwegen bij het kiezen van perioperatieve pijnstilling.","abstract_original":"Opioid receptors and peptides act as modulators of cardiac and vascular function. These effects are mediated not only by central mechanisms but also via a local cardiac opioid system, which has gained increasing attention for its potential role in cardiovascular disease and perioperative medicine. In ischemia-reperfusion injury, opioids have been associated with cardioprotective effects in preclinical models and have also been investigated clinically. In contrast, opioid administration in heart failure has been linked to adverse outcomes, including higher in-hospital mortality and an increased need for ventilatory support. Accordingly, opioid effects on cardiac function and hemodynamic regulation are particularly relevant in heart failure. This review provides an overview of the cardiac opioid system, highlights functional differences in heart failure and ischemia-reperfusion injury, and places these mechanistic insights in a clinical context, outlining therapeutic implications and cardiovascular risks of perioperative opioid use."}