title: Impact of propofol anesthesia induction on cardiac function in low-risk patients as measured by intraoperative Doppler tissue imaging.
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.
authors.affiliation: Department of Cardiovascular Medicine, Konkuk University Medical Center, Seoul, Korea.
authors.forename: Hyun Suk
authors.initials: HS
authors.lastname: Yang
authors.forename: Bong Gun
authors.initials: BG
authors.lastname: Song
authors.forename: Jee Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Soo-Nyung
authors.initials: SN
authors.lastname: Kim
authors.forename: Tae-Yop
authors.initials: TY
authors.lastname: Kim
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D007432:Intraoperative Period; D008991:Monitoring, Physiologic; D009200:Myocardial Contraction / Q000187:drug effects*; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013599:Systole; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol