Key result
General anesthesia and mechanical ventilation are linked to a ~12% relative reduction in LV-GLS.
Why the study?
The modifications of left ventricular systolic function assessed with global longitudinal strain after general anesthesia and invasive mechanical ventilation are poorly described.
Does general anesthesia and invasive mechanical ventilation alter left ventricular global longitudinal strain in patients without cardiovascular comorbidities?
Observational (n=27)
No
Does general anesthesia and invasive mechanical ventilation alter left ventricular global longitudinal strain in patients without cardiovascular comorbidities?
Absolute Event Rate: -18.2% vs -20.6%
p-value: p=<0.05
General anesthesia and invasive mechanical ventilation transiently impair left ventricular systolic function assessed by GLS in healthy patients, though values remain within normal ranges and recover after extubation.
GLS impairment after anesthesia and ventilation stays within normal range in healthy patients; hypothesis-generating for perioperative monitoring.
BACKGROUND: The modifications of left ventricular systolic function assessed with global longitudinal strain (GLS) after general anesthesia and invasive mechanical ventilation are poorly described. METHODS: This was a single-center observational study. ASA I-II patients undergoing routine surgical procedures requiring anesthesia with invasive mechanical ventilation had serial trans-thoracic speckle-tracking echocardiography: at baseline, five minutes after anesthesia and invasive mechanical ventilation, one minute after passive leg raising and after extubation. The primary objective was to evaluate the modification of left ventricular systolic function, assessed with GLS, under anesthesia and mechanical ventilation. Secondary objectives were to evaluate the alterations of GLS after pre-load modifications with passive leg raising and after extubation. RESULTS: From November 2016 to July 2017, 27 patients were included. Baseline left ventricular ejection fraction (LVEF: 60% [56-63]) and GLS (-20.6% [-23.2/-19.2]) were within normal ranges. After anesthesia, LVEF was not altered but GLS showed a significant decrease (-18.2% [-20.4/-17.1], P<0.05). After passive leg raising, GLS was significantly impaired compared with baseline (-17.6% [-19.7/-15], P<0.05) and seven (26%) patients presented systolic function impairment (GLS >-16%). GLS was similar to baseline after extubation (-21.7% [-23.1/-19.5], P>0.05). CONCLUSIONS: Systolic function assessed with GLS is impaired after general anesthesia and invasive mechanical ventilation in patients without cardiovascular co-morbidities but remains within normal range.
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Cinotti et al. (2020) conducted an observational in Patients undergoing routine surgical procedures requiring anesthesia (n=27). General anesthesia and invasive mechanical ventilation vs. Baseline (pre-anesthesia) was evaluated on Modification of left ventricular systolic function assessed with global longitudinal strain (GLS) (p=<0.05). General anesthesia and invasive mechanical ventilation significantly decreased left ventricular global longitudinal strain compared to baseline (-18.2% vs -20.6%, P<0.05), though it remained within normal ranges.
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