title: The Effects of Dexmedetomidine on Myocardial Function Assessed by Tissue Doppler Echocardiography During General Anesthesia in Patients With Diastolic Dysfunction: A CONSORT-Prospective, Randomized, Controlled Trial.
abstract: Dexmedetomidine is a commonly used sedative and adjuvant agent to general anesthesia. The present was designed to evaluate the effects of dexmedetomidine on myocardial function by using tissue Doppler echocardiography during general anesthesia in patients with diastolic dysfunction.Forty patients undergoing orthostatic surgery with ejection fraction preserved diastolic dysfunction grade 2 or 3 were randomly allocated to the Control and Dex group (n = 20, each). In the Dex group, dexmedetomidine was given as an initial loading dose of 1.0 μg/kg over 10 minutes followed by a maintenance dose of 0.5 μg/kg/h. The ratio of peak early diastolic transmitral or transtricuspid inflow velocity to early diastolic mitral or tricuspid annular velocity (LV or RV E/e') and left or right ventricular myocardial performance index (LV or RV MPI) were measured at before and after the administration dexmedetomidine or saline.The Dex group showed significant decrease of heart rate (P = 0.038), and increase of mean blood pressure (P < 0.001), LV E/e' (P = 0.025), and LV MPI (P < 0.001) compared to those of the Control group on a linear mixed model analysis. Also, the Dex group showed significant increase of RV E/e' (P < 0.001) and RV MPI (P = 0.028) compared to those of the Control group.Intraoperative dexmedetomidine administration during general anesthesia was appeared to deteriorate biventricular function in patients with diastolic dysfunction. We suggest careful consideration and a need for reducing dosage when administrating dexmedetomidine in patients with diastolic dysfunction.
authors.affiliation: From the Department of Anesthesiology and Pain Medicine (SHL, SN, NK, MGB, SES, YJO); and Anesthesia and Pain Research Institute, Yonsei University College of Medicine (SHL, SN, NK, YJO), Seoul, Korea.
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Sungwon
authors.initials: S
authors.lastname: Na
authors.forename: Namo
authors.initials: N
authors.lastname: Kim
authors.forename: Min Gi
authors.initials: MG
authors.lastname: Ban
authors.forename: Sung Eui
authors.initials: SE
authors.lastname: Shin
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Oh
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020927:Dexmedetomidine / Q000494:pharmacology*; D003971:Diastole; D004311:Double-Blind Method; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000187:drug effects* / Q000502:physiology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology*; D007430:Intraoperative Care; D008297:Male; D011446:Prospective Studies
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine