2019 Volume 40 Issue 2 Pages 101-107
【 Objectives】 We performed a systematic review of randomized controlled trials （RCTs） to assess the effects of inotropic agent administration on left ventricular diastolic function in adult cardiac surgery patients. 【 Methods】 A systematic search was conducted using Medline and PubMed during the period between January 2003 and October 2017. Inclusion criteria were RCTs conducted in adult patients to assess effects of inotropic agent administration on left ventricular diastolic function using transesophageal echocardiography during the operation. Non-English language papers, animal studies, pediatric studies, and in vitro studies were excluded. 【Results】 Seven RCTs were selected to assess the effects of inotropic agents on left ventricular diastolic function. Four inotropic agents including epinephrine, milrinone, enoximone and levosimendan were evaluated in those RCTs. Epinephrine administration and milrinone administration were evaluated in 2 RCTs and 4 RCTs, respectively, and there was no significant difference in left ventricular diastolic function. Enoximone administration was studied in one RCT and it improved Dct and S/D significantly. However, this change using enoximone was comparable to that in the control group. Levosimendan administration was evaluated in 2 RCTs and it significantly improved left ventricular diastolic function as indicated by measurements of DcT, IVRT, E/E’ and Vp. 【Conclusions】 In our systematic review, we found that there is still limited information on the effects of inotropic agents on left ventricular diastolic function in adult cardiac surgery patients. Results of RCTs suggested that administration of levosimendan, but not administration of other inotropic agents, may improve left ventricular diastolic function.
