Journal of Cardiothoracic and Vascular Anesthesia
Volume 24, Issue 2 , Pages 244-249 , April 2010

Milrinone Improves Diastolic Function in Coronary Artery Bypass Surgery as Assessed by Acoustic Quantification and Peak Filling Rate: A Prospective Randomized Study

  • Birger Axelsson, MD

      Affiliations

    • Department of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital, Örebro, Sweden
    • Corresponding Author InformationAddress reprint requests to Birger Axelsson, MD, Department of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital, SE-701 85 Örebro, Sweden
  • ,
  • Mikael Arbeus, MD

      Affiliations

    • Department of Cardiothoracic Surgery and Anesthesiology, Örebro University Hospital, Örebro, Sweden
  • ,
  • Anders Magnuson, BSc

      Affiliations

    • Statistical and Epidemiological Unit, Örebro University Hospital, Örebro, Sweden
  • ,
  • Jan Hultman, MD, PhD

      Affiliations

    • Thoracic Clinic, Karolinska University Hospital, Stockholm, Sweden

References 

  1. Levy JH, Bailey JM. Phosphodiesterase inhibitors: The inotropes of choice for the new millennium. J Cardiothorac Vasc Anesth. 2000;14:365–366
  2. Lowes BD, Simon MA, Tsvetkova TO, et al. Inotropes in the beta-blocker era. Clin. Cardiol. 2000;23(suppl III):11–16
  3. Bristow MR, Shakar SF, Linseman JV, et al. Inotropes and beta-blockers: is there a need for new guidelines?. J Card Fail. 2001;7:8–12
  4. Feneck RO, Sherry KM, Withington PS, et al. Comparison of the hemodynamic effects of milrinone with dobutamine in patients after cardiac surgery. J Cardiothorac Vasc Anesth. 2001;15:306–315
  5. Monrad ES, Baim DS, Smith HS, et al. Effects of milrinone on coronary hemodynamics and myocardial energetics in patients with congestive heart failure. Circulation. 1985;71:972–979
  6. Grose R, Strain J, Greenberg M, et al. Systemic and coronary effects of intravenous milrinone and dobutamine in congestive heart failure. J Am Coll Cardiol. 1986;7:1107–1113
  7. Monrad ES, Baim DS, Smith HS, et al. Milrinone, dobutamine and nitroprusside: comparative effects on hemodynamics and myocardial energetics in patients with severe congestive heart failure. Circulation. 1986;73:168–174
  8. Liu JJ, Doolan LA, Xie B, et al. Direct vasodilator effects of milrinone, an inotropic drug, on coronary arterial bypass grafts. J Thorac Cardiovasc Surg. 1997;113:108–113
  9. Arbeus M, Axelsson B, Friberg ö, et al. Milrinone increases flow in coronary artery bypass grafts after cardiopulmonary bypass: A prospective, randomized, double blind, placebo-controlled study. J Cardiothorac Vasc Anesth. 2009;23:48–53
  10. Herman C, Sullivan JA, Buth K, et al. Intraoperative graft flow measurements during coronary artery bypass surgery predict in-hospital outcomes. Interact Cardiovasc Thorac Surg. 2008;7:582–585
  11. Doolan LA, Jones EF, Kalman J, et al. A placebo-controlled trial verifying the efficacy of milrinone in weaning high-risk patients from cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1997;11:37–41
  12. Lobato EB, Florete O, Bingham HL. A single dose of milrinone facilitates separation from cardiopulmonary bypass in patients with pre-existing left ventricular dysfunction. Br J Anaesth. 1998;81:782–784
  13. Zile MR, Baicu CF, Gaasch WH. Diastolic heart failure–Abnormalities in active relaxation and passive stiffness of the left ventricle. N Engl J Med. 2004;350:1953–1959
  14. Bernard F, Denault A, Babin D, et al. Diastolic dysfunction is predictive of difficult weaning from cardiopulmonary bypass. Anesth Analg. 2001;92:291–298
  15. Salem R, Denault AY, Couture P, et al. Left ventricular end-diastolic pressure is a predictor of mortality in cardiac surgery independently of left ventricular ejection fraction. Br J Anaesth. 2006;97:292–297
  16. Villars PS, Hamlin SK, Shaw AD, et al. Role of diastole in left ventricular function, I: Biochemical and biomechanical events. Am J Crit Care. 2004;13:394–403
  17. Hamlin SK, Villars PS, Kanusky JT, et al. Role of diastole in left ventricular function, II: Diagnosis and treatment. Am J Crit Care. 2004;13:453–466
  18. Bednarz JE, Marcus RH, Lang RM. Technical guidelines for performing automated border detection studies. J Am Soc Echocardiogr. 1995;8:293–305
  19. Spencer KT, Lang RM, Kirkpatrick JN, et al. Assessment of global and regional left ventricular diastolic function in hypertensive heart disease using automated border detection techniques. Echocardiography. 2003;20:673–681
  20. Moidl R, Chevtchik O, Simon P, et al. Noninvasive monitoring of peak filling rate with acoustic quantification echocardiography accurately detects acute cardiac allograft rejection. J Heart Lung Transplant. 1999;18:194–201
  21. Angomachalelis N, Hourzamanis A, Vakalis D, et al. Acoustic quantification: new diastolic indices of left ventricular function in hypertension; correlation with Doppler echocardiography. Postgrad Med J. 1994;70(suppl I):S57–S66
  22. Muscholl MW, Kurzidim K, Pfeifer M, et al. Assessment of left ventricular diastolic filling in arterial hypertension: comparison of pulsed Doppler echocardiography and acoustic quantification. Am J Hypertens. 1998;11:1032–1036
  23. Hausmann B, Muurling S, Stauch C, et al. Detection of diastolic dysfunction: Acoustic quantification (AQ) in comparison to Doppler echocardiography. Int J Card Imaging. 1997;13:301–310
  24. Chenzbraun A, Pinto FJ, Popylisen S, et al. Comparison of acoustic quantification and Doppler echocardiography in assessment of left ventricular diastolic variables. Br Heart J. 1993;70:448–456
  25. Vandenberg BF, Lindower PD, Lewis J, et al. Reproducibility of left ventricular measurements with acoustic quantification: The influence of training. Echocardiography. 2000;17:631–637
  26. Clements FM, Harpole DH, Quill T, et al. Estimation of left ventricular volume and ejection fraction by two-dimensional transoesophageal echocardiography: Comparison of short-axis imaging and simultaneous radionuclide angiography. Br J Anaesth. 1990;64:331–336
  27. Lundell A, Bergqvist D, Mattsson E, et al. Volume blood flow measurements with a transit time flowmeter: An in vivo and in vitro variability and validation study. Clin Physiol. 1993;13:547–557
  28. Aybek T, Kahn MF, Dogan S, et al. Cardiopulmonary bypass impairs left ventricular function determined by conductance catheter measurements. Thorac Cardiovasc Surg. 2003;51:301–305
  29. De Hert SG, Rodrigus IE, Haenen LR, et al. Recovery of systolic and diastolic left ventricular function early after cardiac bypass. Anesthesiology. 1996;85:1063–1075
  30. Sugihara H, Inagaki S, Nakagawa T, et al. An examination of left ventricular peak filling rate and ventricular relaxation rate by simultaneous acquisition of radionuclide ventriculography and left ventricular pressure. Kaku Igaku. 1989;26:1493–1501
  31. Schulman DS, Herman BA, Edwards TD, et al. Diastolic dysfunction in cardiac transplant recipients: an important role in the response to increased afterload. Am Heart J. 1993;125:435–442
  32. Gillebert TC, Leite-Moreira AF, De Hert SG. Load dependent diastolic dysfunction in heart failure. Heart Fail Rev. 2000;5:345–355
  33. LeWinter MM, Wu Y, Labeit S, et al. Cardiac titin: Structure, function and role in disease. Clin Chim Acta. 2007;375:1–9
  34. Arbogast R. Effects of phosphodiesterase inhibitors on diastolic function. Arch Mal Coeur Vaiss. 1993;86:65–69
  35. Brecker SJ, Xiao HB, Mbaissouroum M, et al. Effects of intravenous milrinone on left ventricular function in ischemic and idiopathic dilated cardiomyopathy. Am J Cardiol. 1993;71:203–209
  36. Colucci WS. Cardiovascular effects of milrinone. Am Heart J. 1991;121:1945–1947
  37. Rettig GF, Schieffer HJ. Acute effects of intravenous milrinone in heart failure. Eur Heart J. 1989;10(suppl C):39–43
  38. Couture P, Denault AY, Pellerin M, et al. Milrinone enhances systolic, but not diastolic function during coronary artery bypass grafting surgery. Can J Anesth. 2007;54:509–522
  39. Yano M, Kohno M, Ohkusa T, et al. Effect of milrinone on left ventricular relaxation and Ca2+ uptake function of cardiac sarcoplasmic reticulum. Am J Physiol Heart Circ Physiol. 2000;279:H1898–H1905
  40. Tanigawa T, Yano M, Kohno M, et al. Mechanism of preserved positive lusitropy by cAMP-dependent drugs in heart failure. Am J Physiol Heart Circ Physiol. 2000;278:H313–H320

 This work was supported by the Research Committee of Örebro County Council, Örebro, Sweden.

PII: S1053-0770(09)00366-8

doi: 10.1053/j.jvca.2009.10.007

Journal of Cardiothoracic and Vascular Anesthesia
Volume 24, Issue 2 , Pages 244-249 , April 2010