Comparison of left ventricular diastolic function parameters in patients induced with propofol and etomidate: A randomized clinical trial

Abstract Background and Aims: Anesthetic agents like propofol and etomidate are known to affect intracellular calcium homeostasis during diastole. Hence, this study has been designed to study the effects of etomidate and propofol on left ventricular diastolic function in adults (>18 years) undergoing elective noncardiac surgery under general anaesthesia. Material and Methods: E-wave velocity, septal and lateral e’ velocities, left atrial volume index (LAVI), and tricuspid regurgitation maximum jet velocity (TRVmax) were measured before and after induction of anesthesia (etomidate and propofol). Results: A total of 187 patients were screened, and parameters from 157 patients were analyzed in this study. There was a statistically significant decrease in the mean E velocity, septal e’, and lateral e’ velocities with both propofol and etomidate. The difference-in-difference analysis revealed that etomidate caused a statistically significant reduction in E velocity (−11.59 ± 6.61 vs. −6.46 ± 9.84, P = 0.0002) compared with propofol. Conclusions: This study found that anaesthesia induction with propofol and etomidate in adults resulted in a statistically significant decrease in E-wave, septal, and lateral e’ velocities within the groups. The reduction in E-wave velocity caused by etomidate was more profound when compared with propofol. While both propofol and etomidate may mildly worsen certain parameters of diastolic function, this study did not demonstrate any worsening of diastolic parameters like LAVI, TRVmax, and E/e’.