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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2010 September;76(9):707-13

lingua: Inglese

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.

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