Midazolam and dexmedetomidine sedation impair systolic heart function

BACKGROUND: Sedation is an essential part of clinical practice.Despite this fact, we still lack data describing the exact impact of sedation on heart function.PURPOSE: To compare the changes in heart function, induced after sedation with either midazolam or dexmedetomidine, using cardiac magnetic resonance imaging (MRI).METHODS: A total number of 30 volunteers were randomized into two groups: 15 participants in the midazolam group (MID) and 15 participants in the dexmedetomidine group (DEX).Every participant underwent a one-session cardiac MRI before and after sedation onset.The following parameters were recorded: left and right ventricle stroke volume (Ao-vol and Pul-vol resp.) and maximum fl ow velocity through the mitral valve during early (E-diast) and late diastole (L-diast).A monitor recorded values of mean blood pressure (MAP), pulse (P) and blood oxygen saturation (SpO 2 ) in 5-minute intervals.RESULTS: Dexmedetomidine led to a statistically signifi cant decrease in Ao-vol (p = 0.006) and Pul-vol (p = 0.003), while midazolam decreased E-diast (p = 0.019) Ao-vol (p = 0.001) and Pul-vol (p = 0.01).The late diastolic fi lling was not infl uenced by the sedation technique.CONCLUSION: Both sedation regimens worsened the systolic function of both ventricles.Midazolam moreover attenuated early diastolic fi lling of the left ventricle (Tab.3, Fig. 4, Ref. 19).