Effect of Sevoflurane Anesthesia on Diastolic Function: A Prospective Observational Study

Area of Science:

• Cardiology
• Anesthesiology
• Cardiovascular Physiology

Background:

• The impact of sevoflurane on left ventricular diastolic function requires further elucidation.
• This study investigated whether sevoflurane anesthesia could improve diastolic function in patients with pre-existing diastolic dysfunction.

Purpose of the Study:

• To compare the effects of sevoflurane on diastolic function parameters between patients with and without pre-existing diastolic dysfunction.
• To assess changes in echocardiographic measures of diastolic function under sevoflurane anesthesia.

Main Methods:

• An observational study involving 60 patients undergoing surgery, categorized into diastolic dysfunction (n=34) and normal (n=26) groups based on septal e' velocity.
• Two thoracic echocardiograms (TTEs) were performed: before anesthesia and during sevoflurane maintenance (0.8-1 MAC) with spontaneous breathing.
• Primary endpoint was the percentage change in septal e' (Δe'); secondary endpoints included ΔE/e', Δleft atrial volume index (ΔLAVI), and Δtricuspid regurgitation maximum velocity (ΔTR Vmax).

Main Results:

• Septal e' (Δe'), mitral inflow E wave velocity (E), E/A ratio (E/A), and deceleration time (DT) significantly improved in the diastolic dysfunction group compared to the normal group (P < .001).
• Left atrial volume index (LAVI) decreased in the diastolic dysfunction group but without statistical significance between groups (P = .091).
• No significant difference in ΔE/e' was observed between the two groups (P = .853).

Conclusions:

• Sevoflurane anesthesia led to significant improvements in echocardiographic parameters of diastolic function in patients with pre-existing diastolic dysfunction.
• Diastolic function parameters remained unchanged in patients with normal diastolic function under sevoflurane anesthesia.
• These findings suggest a potential benefit of sevoflurane in managing diastolic dysfunction during anesthesia.