Sevoflurane effects on left atrial performance: a transesophageal echocardiographic study on patients undergoing coronary artery bypass grafting

Abstract

Abstract Background Patients presenting for coronary artery bypass grafting often have left ventricular diastolic dysfunction. These patients are in need for a well contracting left atrium (LA) to generate the required cardiac output. Sevoflurane affects the overall cardiac contractility. This study aimed at evaluating sevoflurane effects on left atrial performance and left ventricular diastolic function for patients undergoing coronary artery bypass graft (CABG) using transesophageal echocardiography (TEE). Results Out of 40 enrolled patients, analysis was made for 31 patients. Results after exposure to one MAC sevoflurane revealed a decrease of left atrial functional area change (P = 0.001), left atrial active emptying fraction (P = 0.038), and A wave velocity by transmitral pulsed wave Doppler (P = 0.019) while left ventricular diastolic function was unaffected despite a significant decrease in left ventricular ejection fraction (P = 0.008). Conclusions Sevoflurane at one MAC affected the left atrial performance without affecting left ventricular diastolic function in patients with grade I and II diastolic dysfunction undergoing CABG. Trial registration NCT03999463.