Impact of Propofol Anesthesia Induction on Cardiac Function in Low-Risk Patients as Measured by Intraoperative Doppler Tissue Imaging

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Abstract

Background:

Despite a few experimental studies showing a dose-dependent myocardial depressive effect of propofol anesthesia induction, few clinical data are available to determine its precise impact on myocardial function, probably because of its brevity and a lack of appropriate evaluation tools. The purpose of this study was to examine the impact of propofol-based anesthesia induction on left ventricular (LV) function using Doppler tissue and speckle-tracking imaging.

Methods:

In 19 low-risk patients with normal LV systolic and diastolic function undergoing noncardiac surgery (all women; mean age, 42 years), propofol bolus (2.0 mg/kg) was administered intravenously for anesthesia induction. LV ejection fraction, global peak systolic longitudinal strain, and tissue Doppler–derived indices of mitral annular velocity during systole (S′), early diastole (e′), and atrial contraction (a′) were determined by intraoperative transthoracic echocardiography before and 1, 3, and 5 min after propofol bolus (T0, T1, T2, and T3, respectively).

Results:

The following at T1, T2, and T3 were significantly less in magnitude than at T0: septal S′ (5.61, 5.61, and 5.51 vs 7.60 cm/sec, P < .001), lateral S′ (5.75, 5.89, and 5.94 vs 8.12 cm/sec, P < .001), septal e′ (10.10, 10.26, and 10.07 vs 11.4 cm/sec, P < .01), septal a′ (6.70, 6.21, and 6.13 vs 8.58 cm/sec, P < .01), lateral a′ (7.29, 6.81, and 6.85 vs 9.01 cm/sec, P < .01), and longitudinal strain (−19.36%, −19.71%, and −19.61% vs −22.28%, P < .001). LV ejection fraction was not significantly changed (P = .361).

Conclusions:

Propofol anesthesia induction diminished LV and atrial contraction in low-risk patients with prior normal LV function. Further studies are needed to understand the clinical implications, particularly for higher risk populations.

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