The Effects of Propofol on Left Ventricular Global Longitudinal Strain

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Objectives: To determine if hemodynamic changes secondary to propofol administration are a result of direct myocardial depression as measured by global longitudinal strain (GLS). The authors hypothesized that propofol would cause a significant worsening in GLS, indicating direct myocardial depression. Design: Prospective, observational. Setting: Endoscopy suite at a single academic medical center. Participants: Patients undergoing outpatient, elective endoscopic procedures at an outpatient clinic of a single tertiary care academic medical center. Interventions: None. Measurements and Main Results: Limited transthoracic echocardiograms were performed before and after patients received propofol for endoscopic procedures. Post-processing measurements included GLS, 2D (dimensional) ejection fraction (2D EF), and 3D EF. Using paired sample Student’s t test, no statistically significant change in GLS, 2D EF, or 3D EF was found despite statistically significant hypotension. In fact, there was a trend toward more negative GLS (improved myocardial function) in patients after receiving propofol. Conclusion: We found propofol did not cause a reduction in systolic function as measured by GLS, a sensitive measure of myocardial contractility. Therefore, decreases in blood pressure after a propofol bolus in spontaneously breathing patients are likely due to decreased vascular tone and not impaired left ventricular systolic function. These results should be considered in the management of propofol-induced hypotension for spontaneously breathing patients.

Original languageEnglish (US)
Pages (from-to)185-190
Number of pages6
JournalSeminars in Cardiothoracic and Vascular Anesthesia
Issue number3
StatePublished - Sep 2021

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine


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