Milrinone improves diastolic function in coronary artery bypass surgery as
assessed by acoustic quantification and peak filling rate: a prospective
randomized study.
Author(s): Axelsson B, Arbeus M, Magnuson A, Hultman J.
Affiliation(s): Department of Cardiothoracic Surgery and Anesthesiology, Orebro University
Hospital, Orebro, Sweden. birger.axelsson@orebroll.se
Publication date & source: 2010, J Cardiothorac Vasc Anesth. , 24(2):244-9
OBJECTIVE: To compare the effects of a bolus dose of milrinone, 50 microg/kg, to
placebo on diastolic function (active relaxation) in patients undergoing on-pump
coronary artery bypass grafting (CABG).
DESIGN: Prospective, randomized, double-blind, placebo-controlled study.
SETTING: University hospital.
PARTICIPANTS: Twenty-four patients with stable angina and left ventricular
ejection fraction >30%, scheduled for elective CABG using cardiopulmonary bypass
(CPB), were included.
INTERVENTION: Patients were randomized to receive either 50 microg/kg of
milrinone (n = 12) or placebo (n = 12) after aortic declamping.
MEASUREMENTS AND MAIN RESULTS: The diastolic function of the left ventricle (LV)
was measured as peak filling rate (dA/dt [maximal diastolic area change over
time]) with transesophageal echocardiography (TEE) using acoustic quantification
(AQ) before CPB and 10 minutes after termination of CPB. The normalized peak
filling rate (dA/dt)/EDA was also calculated. Active relaxation was statistically
significantly increased in the milrinone group compared with the placebo group
after CPB.
CONCLUSION: Patients undergoing CABG surgery and treated with milrinone after
aortic declamping had better diastolic function following cardiopulmonary bypass.
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