Document Detail

Effects of desflurane and sevoflurane on length-dependent regulation of myocardial function in coronary surgery patients.
MedLine Citation:
PMID:  11506106     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Desflurane and sevoflurane have negative inotropic effects. The current study investigated whether these effects resulted in an altered left ventricular response to increased cardiac load and affected length-dependent regulation of myocardial function. Length-dependent regulation of myocardial function refers to the ability of the heart to improve its performance when preload is increased. METHODS: A high-fidelity pressure catheter was positioned in the left ventricle and left atrium in 20 coronary surgery patients with a preoperative ejection fraction greater than 40%. Studies were performed before the initiation of cardiopulmonary bypass. Left ventricular response to increased cardiac load, obtained by leg elevation, was assessed during control conditions and during increasing concentrations of desflurane (2, 4, and 6% end tidal; n = 10) or sevoflurane (1, 2, and 3% end tidal; n = 10). Effects on contraction were evaluated by analysis of changes in maximal rate of pressure development. Effects on relaxation were assessed by analysis of changes in minimum rate of pressure development and by analysis of the load dependence of myocardial relaxation (R = slope of the relation between time constant tau of isovolumic relaxation and end-systolic pressure). Peak left atrial-left ventricular pressure gradients were analyzed during early left ventricular filling. RESULTS: With both desflurane and sevoflurane, maximal and minimum rates of pressure development decreased while tau increased. Peak left atrial-left ventricular pressure gradients remained unchanged. The hemodynamic effects of leg elevation were similar at the different concentrations. Changes in parameters of contraction and relaxation during leg elevation were coupled and were not altered by desflurane or sevoflurane. CONCLUSIONS: Despite their negative inotropic and lusitropic effects, neither desflurane nor sevoflurane adversely affect length-dependent regulation of left ventricular function. In the conditions of our study, the ability of the left ventricular to respond to increased cardiac load is not altered by the use of desflurane or sevoflurane.
S G De Hert; P J Van der Linden; P W ten Broecke; K T Vermeylen; I E Rodrigus; B A Stockman
Related Documents :
1381796 - Hypertensive heart disease: pathophysiology and clinical and prognostic consequences.
1334466 - Effectiveness of the antihypertensive action of lisinopril on left ventricular mass and...
9746126 - Atherosclerosis and left ventricular hypertrophy: persisting problems in treated hypert...
4076126 - Observations on seven cases of mitral insufficiency in the horse.
842636 - Effect of secretin on renal blood flow, interstitial pressure, and sodium excretion.
8996806 - Effects of high helium pressure on intracellular and field potential responses in the c...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  95     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-16     Completed Date:  2001-08-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  357-63     Citation Subset:  AIM; IM    
Department of Anesthesiology, University Hospital Antwerp, Edegem, Belgium.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anesthetics, Inhalation*
Atrial Function, Left / drug effects,  physiology
Coronary Artery Bypass*
Dose-Response Relationship, Drug
Heart / drug effects,  physiology*
Hemodynamics / drug effects
Isoflurane* / analogs & derivatives
Leg / blood supply
Methyl Ethers*
Middle Aged
Regional Blood Flow / drug effects,  physiology
Ventricular Function, Left / drug effects
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 26675-46-7/Isoflurane; 28523-86-6/sevoflurane; 57041-67-5/desflurane

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requ...
Next Document:  Auditory evoked potential index predicts the depth of sedation and movement in response to skin inci...