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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2010 September;76(9):707-13
Effects of fenoldopam on myocardial function (strain rate) in patients with coronary artery disease undergoing cardiac surgery
Pittarello D., Bonato R., Falasco G., Tiberio I., Gasparetto M., Ori C. ✉
Unit of Anesthesia and Intensive Care, Department of Pharmacology and Anesthesiology, University of Padua, Italy
BACKGROUND: This study aimed to assess the effects of fenoldopam, an antihypertensive agent with nephroprotective properties, on myocardial function. The global systolic and diastolic function and the strain rate, a new parameter used to quantify regional myocardial function, were measured with transesophageal echocardiography.
METHODS:Forty patients undergoing elective coronary artery surgery were analyzed in a prospective nonrandomized clinical trial. Patients were divided into two groups, a group that received 0.05-mcg/kg/min fenoldopam (20 patients) and a control group (20 patients). Only patients with serum creatinine levels ≥120 µmol/L and critical coronary stenosis were selected. The ejection fraction (EF), the E and A waves, and the E/A ratio were measured with transesophageal echocardiography, and the strain rate was calculated using a strain quantification program to measure the peak systolic strain rate (PSSR) and the peak diastolic strain rate (PDSR).
RESULTS: Fenoldopam did not change the systolic and diastolic global function (EF, E wave, A wave and E/A). Regarding regional myocardial function, fenoldopam significantly increased the PSSR from -1.09±0.8 1/s to -2.24±2.26 1/s (P=0.038) and the PDSR from 1.04±0.69 1/s to 1.69±0.87 1/s (P=0.012).
CONCLUSION: Low doses of fenoldopam increased the regional myocardial function, as assessed by the myocardial strain rate, in patients undergoing cardiac surgery.