Effects of dobutamine with those of milrinone on myocardial strain in patients undergoing valve replacement surgery
- VernacularTitle:瓣膜置换术患者心肺转流后多巴酚丁胺与米力农对心肌应变力的影响
- Author:
Tingting WANG
1
;
Hongwei SHI
;
Xinyi BU
;
Haiyan WEI
;
Yali GE
;
Zhonghong SU
;
Tao SHI
Author Information
- Keywords: Dobutamine; Milrinone; Valve replacement; Myocardial strain; Cardiopulmonary bypass
- From: The Journal of Clinical Anesthesiology 2019;35(1):32-37
- CountryChina
- Language:Chinese
- Abstract: Objective To compare the effects of dobutamine with those milrinone on myocardial strain in patients undergoing valve replacement surgery.Methods Fifty-five patients udergoing valve replacement surgery, 27 males and 28 females, aged 40-75 years, falling into ASA physical statusⅡ orⅢ, New York Heart Association (NYHA) ⅡorⅢ, were included in this study.They were divided into 3 groups by using a random number table:intravenous infusion dobutamine group (group D, n=18), intravenous infusion milrinone group (group M, n=20) and intravenous infusion saline group (group C, n=17).All patients were used general anesthesia.In groups D, the patients received intravenous infusion dobutamine (4μg·kg-1·min-1) for an hour starting from 15 min after termination of CPB.In group M, the patients did intravenous infusion milrinone (0.4μg·kg-1·min-1) in the same way.In group C, the patients got intravenous infusion saline also.After induction of anesthesia, these patients were recorded for hemodynamic measurement at three points after induction of anesthesia and before splitting of sternum (T0), starting from 15 min after termination of CPB (T1), intravenous infusion medicine for 30 min (T2), intravenous infusion medicine for one hour (T3):HR, CVP, cardiac output (CO), left ventricular ejection fraction (LVEF), right ventricular fractional area change (RVFAC), cardiac index (CI) and systemic vascular resistance index (SVRI) and strained indicator:global longitudinal strain of left ventricle (S-LVL), global circumferential strain of the left ventricle (S-LVM), global longitudinal strain of right ventricle (S-RV).Results Compared with group M, HR in group D at T2 and T3 was higher (P<0.05).Compared with group C, HR in group D at T3 was higher (P<0.05).And CI in group D at T2 was higher than that in groups C and M (P<0.05).Compared with groups C, S-LVMin groups D and M at T2 and T3 were stronger, S-LVL, S-RV in group D and S-RV in group M at T3 were stronger (P<0.05).Conclusion Intravenous infusion dobutamine can improve S-LVM, S-LVLand S-RV;Intravenous infusion milrinone can improve S-LVMand S-RV.