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

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. 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. 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. Combined use of landiolol and olprinone increases cardiac index and decreases systemic vascular resistance index during OPCAB.