The Effects of Propofol on Left Ventricular Global Longitudinal Strain.

IF 1.1 Q3 ANESTHESIOLOGY Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2021-09-01 Epub Date: 2021-02-05 DOI:10.1177/1089253221991372
Scott R Coleman, Theodore J Cios, Steven Riela, S Michael Roberts
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引用次数: 1

Abstract

Objectives: To determine if hemodynamic changes secondary to propofol administration are a result of direct myocardial depression as measured by global longitudinal strain (GLS). The authors hypothesized that propofol would cause a significant worsening in GLS, indicating direct myocardial depression.

Design: Prospective, observational.

Setting: Endoscopy suite at a single academic medical center.

Participants: Patients undergoing outpatient, elective endoscopic procedures at an outpatient clinic of a single tertiary care academic medical center.

Interventions: None.

Measurements and main results: Limited transthoracic echocardiograms were performed before and after patients received propofol for endoscopic procedures. Post-processing measurements included GLS, 2D (dimensional) ejection fraction (2D EF), and 3D EF. Using paired sample Student's t test, no statistically significant change in GLS, 2D EF, or 3D EF was found despite statistically significant hypotension. In fact, there was a trend toward more negative GLS (improved myocardial function) in patients after receiving propofol.

Conclusion: We found propofol did not cause a reduction in systolic function as measured by GLS, a sensitive measure of myocardial contractility. Therefore, decreases in blood pressure after a propofol bolus in spontaneously breathing patients are likely due to decreased vascular tone and not impaired left ventricular systolic function. These results should be considered in the management of propofol-induced hypotension for spontaneously breathing patients.

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异丙酚对左心室整体纵向应变的影响。
目的:通过测量全局纵向应变(GLS)来确定异丙酚给药后继发的血流动力学变化是否是直接心肌抑制的结果。作者假设异丙酚会导致GLS显著恶化,表明直接心肌抑制。设计:前瞻性,观察性。设置:内窥镜套房在一个单一的学术医疗中心。参与者:在单一三级保健学术医疗中心门诊接受门诊、选择性内镜手术的患者。干预措施:没有。测量和主要结果:在患者接受异丙酚内镜手术前后进行有限的经胸超声心动图检查。后处理测量包括GLS、2D(尺寸)射血分数(2D EF)和3D EF。采用配对样本Student’st检验,GLS、2D EF和3D EF均无统计学意义的变化,但有统计学意义的低血压。事实上,在接受异丙酚治疗的患者中,GLS(心肌功能改善)有更多的阴性趋势。结论:我们发现异丙酚不会导致GLS测量的收缩功能降低,这是一种敏感的心肌收缩力测量。因此,自主呼吸患者服用异丙酚后血压下降可能是由于血管张力降低而非左心室收缩功能受损。这些结果在处理异丙酚诱导的自主呼吸患者低血压时应予以考虑。
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来源期刊
CiteScore
3.60
自引率
14.30%
发文量
31
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