[Effect of landiolol and combined use of landiolol and olprinone on hemodynamics in patients undergoing off-pump coronary artery bypass grafting].

BACKGROUND: Beta blockers are frequently used to reduce cardiac oxygen demand in off-pump coronary artery bypass grafting (OPCAB). However, significant bradycardia or negative inotropic effects are seen on occasion. We hypothesized that combined use of landiolol (L), an ultra short-acting beta blocker, and olprinone (O), a phosphodiesterase 3 inhibitor, is useful because it can increase cardiac index and prevent tachyarrhythmia even during dislocation of the heart in OPCAB. METHODS: Twenty-four patients were divided into two groups, L group and LO group randomly. Landiolol infusion was started at a rate of 3 microg x kg(-1) x min(-1) for patients in L group and LO group, and olprinone infusion was administered at a rate of 0.2 microg x kg(-1) x min(-1) for 90 minutes followed by 0.1 microg x kg(-1) x min(-1) for patients in LO group. Intra-aortic balloon pumping and atrial pacing were initiated for patients with expected unstable hemodynamics. RESULTS: Cardiac indices were greater in LO group and systemic vascular resistances were lower in LO group. However, total amount of noradrenaline used was greater in LO group. CONCLUSIONS: Combined use of landiolol and olprinone increases cardiac index and decreases systemic vascular resistance index during OPCAB.