Isoflurane's effect on intraoperative systolic left ventricular performance in cardiac valve surgery patients

Ju Deok Kim, Ilsoon Son, Won kyoung Kwon, Tae Yun Sung, Hanafi Sidik, Karam Kim, Hyun Kang, Jiyon Bang, Gwi Eun Yeo, Dong Kyu Lee, Tae Yop Kim

Research output: Contribution to journalArticle

Abstract

Background: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery. Methods: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography. Results: Mean S' values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were -1.0 (-1.6, -0.3), -1.1 (-1.7, -0.6), and -2.1 (-3.1, -1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001). Conclusion: Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.

Original languageEnglish
Article numbere28
JournalJournal of Korean Medical Science
Volume33
Issue number4
DOIs
Publication statusPublished - 2018 Jan 1

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Isoflurane
Heart Valves
Thoracic Surgery
Transesophageal Echocardiography
Phenylephrine
Left Ventricular Function
Stroke Volume
Anesthetics
Analysis of Variance
Multivariate Analysis
Anesthesia
Confidence Intervals

Keywords

  • Echocardiography
  • Heart function test
  • Isoflurane

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Isoflurane's effect on intraoperative systolic left ventricular performance in cardiac valve surgery patients. / Kim, Ju Deok; Son, Ilsoon; Kwon, Won kyoung; Sung, Tae Yun; Sidik, Hanafi; Kim, Karam; Kang, Hyun; Bang, Jiyon; Yeo, Gwi Eun; Lee, Dong Kyu; Kim, Tae Yop.

In: Journal of Korean Medical Science, Vol. 33, No. 4, e28, 01.01.2018.

Research output: Contribution to journalArticle

Kim, Ju Deok ; Son, Ilsoon ; Kwon, Won kyoung ; Sung, Tae Yun ; Sidik, Hanafi ; Kim, Karam ; Kang, Hyun ; Bang, Jiyon ; Yeo, Gwi Eun ; Lee, Dong Kyu ; Kim, Tae Yop. / Isoflurane's effect on intraoperative systolic left ventricular performance in cardiac valve surgery patients. In: Journal of Korean Medical Science. 2018 ; Vol. 33, No. 4.
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abstract = "Background: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery. Methods: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50{\%} (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography. Results: Mean S' values (95{\%} confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were -1.0 (-1.6, -0.3), -1.1 (-1.7, -0.6), and -2.1 (-3.1, -1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001). Conclusion: Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.",
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T1 - Isoflurane's effect on intraoperative systolic left ventricular performance in cardiac valve surgery patients

AU - Kim, Ju Deok

AU - Son, Ilsoon

AU - Kwon, Won kyoung

AU - Sung, Tae Yun

AU - Sidik, Hanafi

AU - Kim, Karam

AU - Kang, Hyun

AU - Bang, Jiyon

AU - Yeo, Gwi Eun

AU - Lee, Dong Kyu

AU - Kim, Tae Yop

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery. Methods: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography. Results: Mean S' values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were -1.0 (-1.6, -0.3), -1.1 (-1.7, -0.6), and -2.1 (-3.1, -1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001). Conclusion: Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.

AB - Background: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery. Methods: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography. Results: Mean S' values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were -1.0 (-1.6, -0.3), -1.1 (-1.7, -0.6), and -2.1 (-3.1, -1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001). Conclusion: Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.

KW - Echocardiography

KW - Heart function test

KW - Isoflurane

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