ISSN 2149-2263 | E-ISSN 2149-2271 Home      
 
Volume : 20 Issue : 1
Current Issue Archive Popular Article Ahead of Print

   
Quick Search





 
Efficacy of levosimendan in patients with chronic heart failure: Does rhythm matter? [Anatol J Cardiol]
Anatol J Cardiol. 2010; 10(4): 310-316 | DOI: 10.5152/akd.2010.088  

Efficacy of levosimendan in patients with chronic heart failure: Does rhythm matter?

Osman Can Yontar1, Mehmet Birhan Yılmaz2, Kenan Yalta1, İzzet Tandoğan1
1Department of Cardiology Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
2Department of Cardiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey

Ob jec ti ve: Levosimendan is a relatively new inotropic agent. Unlike other inotropic agents, Levosimendan does not increase cellular calcium intake, so that, does not cause intracellular calcium overload and related arrhythmias. Atrial fibrillation (AF) was shown to be an independent risk factor for mortality and morbidity in large heart failure (HF) trials. Heart failure induces AF, AF aggravates HF and therefore they generally coexist. We conducted a study to investigate if there is any differential effect of Levosimendan in HF patients with chronic AF and without AF. Methods: This is a prospective study. Consecutive patients, who were hospitalized because of acutely decompensated HF due to systolic dysfunction and decided Levosimendan administration, were enrolled. Patients were classified into two as those with AF (group A) and those with sinus rhythm (control group, group S). All patients had echocardiography before and after administration. Echocardiographic data were evaluated by ANOVA repeated measurements test. Results: Baseline left ventricle ejection fraction (LVEF) was poorer in group with AF (mean LVEF for group A: 20.9%, for group S: 26.4%, p=0.04). Baseline diastolic parameters were equally impaired. After infusion, diastolic parameters like velocity of propagation (Vp) and isovolumic relaxation time (IVRT) improved almost to same extent in both groups but deceleration time (DT) did not. IVRT values decreased (p=0.012) both in group S (from 108.6±23.2 msec to 100.4±28.4 msec) and group A (from 117.3±25.1 msec to 92.0±20.9 msec) without a significant difference between groups (p=0.180 for interaction). Another valuable diastolic parameter, Vp was also similarly improved (p<0.01) in both groups to similar extent (for group A, from 35.4±8.8 cm/sec to 41.1±7.7 cm/sec, for group S, from 33.7±7.5 cm/sec to 37.8±7.6 cm/sec; p=0.498 for interaction). Conclusion: We have shown that in patients with chronic HF and AF, levosimendan improves left ventricular systolic and diastolic functions as good as those with HF and sinus rhythm. We suggest that a positive electrophysiological effect of levosimendan on failing myocardial tissue seems to fill the absence of atrial booster in patients with AF who are on beta-blocker therapy.

Keywords: Heart failure, levosimendan, atrial fibrillation


Osman Can Yontar, Mehmet Birhan Yılmaz, Kenan Yalta, İzzet Tandoğan. Efficacy of levosimendan in patients with chronic heart failure: Does rhythm matter?. Anatol J Cardiol. 2010; 10(4): 310-316


TOOLS
Full Text PDF
Print
Download citation
RIS
EndNote
BibTex
Medlars
Procite
Reference Manager
Share with email
Share


Similar articles
PubMed
Google Scholar




 
 
KARE Publishing | Copyright © 2018 Turkish Society of Cardiology