Effects of sevoflurane on left ventricular function by speckle-tracking echocardiography in coronary bypass patients: A randomized trial

Abstract

The present study aimed to dynamically observe the segmental and global myocardial movements of the left ventricle during coronary artery bypass grafting (CABG) using transesophageal speckle-tracking echocardiography, and to assess the impact of sevoflurane on cardiac function. Sixty-four patients scheduled for the off-pump CABG were randomly divided into a sevoflurane-based anesthesia (AS) group and a propofol-based total intravenous anesthesia (AA) group. The AS group demonstrated a higher absolute value of left ventricular (LV) global longitudinal strain (GLS) than the AA group at both T₁ (after harvesting all grafts and before coronary anastomosis) and T₂ (30 min after completing all coronary anastomoses) (P < 0.05). Moreover, strain improvement in the segment with the highest preoperative strain was significantly reduced in the AS group, compared with the AA group at both T₁ and T₂ (P < 0.01). The flow of the left internal mammary artery-left anterior descending artery graft was superior, and the postoperative concentration of troponin T (cTnT) decreased rapidly in the AS group compared with the AA group (P < 0.05). Compared with total intravenous anesthesia, sevoflurane resulted in significantly higher GLS, stroke volume, and cardiac output. Sevoflurane also led to an amelioration in the condition of the arterial graft. Furthermore, sevoflurane significantly reduced strain improvement in the segmental myocardium with a high preoperative strain value. The findings need to be replicated in large studies.