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Conscious sedation with midazolam or propofol does not alter left ventricular diastolic performance in patients with preexisting diastolic dysfunction: a transmitral and tissue Doppler transthoracic echocardiography study. Anesth Analg 2001 Oct;93(4):865-71

Date

09/28/2001

Pubmed ID

11574347

DOI

10.1097/00000539-200110000-00012

Scopus ID

2-s2.0-0034813593 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

UNLABELLED: The effects of midazolam and propofol on left ventricular (LV) diastolic function have not been evaluated in humans. We tested the hypothesis that midazolam and propofol alter LV diastolic function evaluated with transmitral and tissue Doppler transthoracic echocardiography in patients with normal LV systolic function in the presence and absence of preexisting diastolic dysfunction. After IRB approval and informed consent, patients (n = 34) with normal or reversed transmitral blood flow velocity E-to-A ratios received 3 escalating doses of midazolam (0.025, 0.05, and 0.1 mg/kg) or propofol (0.25, 0.5, and 1.0 mg/kg) over 10 s at 5-min intervals. Hemodynamic variables and indices of diastolic function were recorded 3 min after each dose of midazolam and propofol. Patients with diastolic dysfunction demonstrated decreased ratios of peak transmitral E-to-A wave velocity and their corresponding time-velocity integrals as compared with normal patients. Reductions in anterior and posterior mitral annulus E/A ratios were also present. Midazolam and propofol did not further alter indices of LV diastolic function in patients with impaired early LV filling. The results indicate that sedation with midazolam or propofol does not affect indices of LV diastolic performance in healthy patients and those with preexisting diastolic dysfunction.

IMPLICATIONS: Sedation with midazolam or propofol does not alter indices of left ventricular diastolic function in healthy patients and those with preexisting left ventricular filling abnormalities as evaluated by transthoracic echocardiography.

Author List

Gare M, Parail A, Milosavljevic D, Kersten JR, Warltier DC, Pagel PS

MESH terms used to index this publication - Major topics in bold

Adult
Diastole
Double-Blind Method
Echocardiography
Female
Heart Rate
Hemodynamics
Humans
Hypnotics and Sedatives
Male
Midazolam
Middle Aged
Mitral Valve
Propofol
Ventricular Dysfunction, Left
Ventricular Function, Left