Effects of fenoldopam on myocardial function (strain rate) in patients with coronary artery disease undergoing cardiac surgery.
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 > or =120 micromol/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).


CONCLUSIONS
Low doses of fenoldopam increased the regional myocardial function, as assessed by the myocardial strain rate, in patients undergoing cardiac surgery.
Pittarello
D
D
Unit of Anesthesia and Intensive Care, Department of Pharmacology and Anesthesiology, University of Padua, Italy. dempit@tin.it
Bonato
R
R
Falasco
G
G
Tiberio
I
I
Gasparetto
M
M
Ori
C
C
D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology*; D006348:Cardiac Surgical Procedures; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D018818:Fenoldopam / Q000494:pharmacology*; D006321:Heart / Q000187:drug effects* / Q000502:physiology*; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D011446:Prospective Studies
D000959:Antihypertensive Agents; D018818:Fenoldopam