| Acute effects of levosimendan on mitral regurgitation and diastolic function in patients with advanced chronic heart failure. | |
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MedLine Citation:
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PMID: 20613551 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We analyzed the inodilator properties of levosimendan in patients with chronic heart failure and severe functional mitral regurgitation. METHODS: We studied 20 patients under optimal treatment and in stable clinical condition (New York Heart Association 3.19 + or - 0.66; 70 + or - 7 years). Levosimendan was infused as a bolus (12 microg/kg in 10 min) followed by a 24-h infusion (0.1-0.2 microg/kg per min). Before and after infusion, Doppler echocardiography, brain natriuretic peptide determination and noninvasive hemodynamic monitoring with bioimpedance cardiography were performed. RESULTS: Levosimendan improved left ventricular ejection fraction (ejection fraction 31 + or - 4 from 27 + or - 4, P < 0.05), decreased brain natriuretic peptide (333 + or - 139 from 629 + or - 63 pg/ml, P < 0.01), reduced mitral valve effective regurgitant orifice area to 27 + or - 5 from 36 + or - 7 mm (P < 0.01) and the velocity of displacement of mitral annulus [ratio between E and E' waves on Doppler and tissue Doppler (E/E') from 22.7 + or - 1.6 to 13.1 + or - 0.6, P < 0.01]. Noninvasive hemodynamic monitoring showed increased acceleration index (a marker of inotropism), and reduced peripheral resistances and thoracic fluid content (P < 0.01). After 4 weeks of washout, some of these effects were still evident. CONCLUSION: In patients with chronic heart failure and functional mitral regurgitation, levosimendan acutely improved systolic and diastolic function, reduced mitral regurgitation and modulated neurohormonal activation, with a tendency for these changes to persist over a short-term follow-up. |
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Authors:
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Giovanna Branzi; Gabriella Malfatto; Alessandra Villani; Francesca Ciambellotti; Miriam Revera; Alessia Giglio; Francesco Della Rosa; Mario Facchini; Gianfranco Parati |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of cardiovascular medicine (Hagerstown, Md.) Volume: 11 ISSN: 1558-2035 ISO Abbreviation: J Cardiovasc Med (Hagerstown) Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-07-30 Completed Date: 2010-11-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101259752 Medline TA: J Cardiovasc Med (Hagerstown) Country: United States |
Other Details:
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Languages: eng Pagination: 662-8 Citation Subset: IM |
Affiliation:
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Divisione di Cardiologia, Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Italy. branzi@auxologico.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiography, Impedance Cardiotonic Agents / administration & dosage, therapeutic use* Chronic Disease Diastole Echocardiography, Doppler Female Heart Failure / diagnosis, drug therapy*, physiopathology Hemodynamics / drug effects Humans Hydrazones / administration & dosage, therapeutic use* Infusions, Intravenous Italy Male Middle Aged Mitral Valve Insufficiency / diagnosis, drug therapy*, physiopathology Natriuretic Peptide, Brain / blood Pilot Projects Pyridazines / administration & dosage, therapeutic use* Severity of Illness Index Stroke Volume / drug effects Systole Time Factors Treatment Outcome Vasodilator Agents / administration & dosage, therapeutic use* Ventricular Function, Left / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 0/Vasodilator Agents; 114471-18-0/Natriuretic Peptide, Brain; 131741-08-7/simendan |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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