• Geir O Dahle, Pirjo-Riitta Salminen, Christian A Moen, Finn Eliassen, Anne K Jonassen, Rune Haaverstad, Knut Matre, and Ketil Grong.
• Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science. Electronic address: geir.olav.dahle@helse-bergen.no.
• J. Cardiothorac. Vasc. Anesth. 2015 Jan 1; 29 (3): 684-93.

ObjectiveThis study investigated if the β-receptor blocking agent esmolol, added to standard oxygenated blood cardioplegia, improved myocardial function after weaning from bypass.DesignA block-randomized, blinded study.SettingA university laboratory.ParticipantsTwenty anesthetized pigs, Norwegian Landrace.InterventionsAfter cardiopulmonary bypass, cardiac arrest was induced with cold (12°C), oxygenated blood cardioplegia, enriched with either esmolol or vehicle, repeated every 20 minutes. After 100 minutes the heart was reperfused and weaned.Measurements And Main ResultsLeft ventricular function was evaluated with pressure-volume loops, local myocardial function with multilayer strain and strain rate by epicardial short-axis tissue Doppler imaging. One hour after declamping, preload recruitable stroke work did not differ between groups, but increased to 72±3 mmHg in esmolol-treated animals v 57±4 mmHg (p<0.001) in controls after 3 hours. Radial peak ejection strain rate also was increased by esmolol; 6.0±1.0 s(-1)v 2.9±0.3 s(-1) (p<0.001) in subendocardium and 3.9±0.5 s(-1)v 2.3±0.2 s(-1) (p<0.005) in the midmyocardium. Cardiac index was increased, 4.0±0.2 L/min/m(2) by esmolol v 3.3±0.1 L/min/m(2) for controls (p<0.05). Isovolumetric relaxation time constant was reduced by esmolol, 23±1 ms v 26±1 ms (p<0.025). Troponin-T did not differ and was 339±48 ng/L for the esmolol group and 357±55 ng/L for the control group (p = 0.81).ConclusionsEsmolol added to blood cardioplegia preserved systolic cardiac function during the first 3 hours after reperfusion in a porcine model with 100 minutes of cardioplegic arrest.Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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