title: Effects of fenoldopam on myocardial function (strain rate) in patients with coronary artery disease undergoing cardiac surgery.
abstract: 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.
authors.affiliation: Unit of Anesthesia and Intensive Care, Department of Pharmacology and Anesthesiology, University of Padua, Italy. dempit@tin.it
authors.forename: D
authors.initials: D
authors.lastname: Pittarello
authors.forename: R
authors.initials: R
authors.lastname: Bonato
authors.forename: G
authors.initials: G
authors.lastname: Falasco
authors.forename: I
authors.initials: I
authors.lastname: Tiberio
authors.forename: M
authors.initials: M
authors.lastname: Gasparetto
authors.forename: C
authors.initials: C
authors.lastname: Ori
mesh_terms: 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
chemical_list: D000959:Antihypertensive Agents; D018818:Fenoldopam