Q: How propofol directly affects cardiac muscles?


Answer:  Propofol effect on myocardium gets pronounced during Propofol Infusion Syndrome (PRIS). It has direct calcium channel blocking properties in myocardium and also promotes inflammation in the cardiac muscle.



References: 

1. W. Zhou, H. J. Fontenot, S. Liu, and R. H. Kennedy, “Modulation of cardiac calcium channels by propofol,” Anesthesiology, vol. 86, no. 3, pp. 670–675, 1997. 

2. W. Jiang, Z.-B. Yang, Q.-H. Zhou, X. Huan, and L. Wang, “Lipid metabolism disturbances and AMPK activation in prolonged propofol-sedated rabbits under mechanical ventilation,” Acta Pharmacologica Sinica, vol. 33, no. 1, pp. 27–33, 2012.