Document Detail


Comparison of ischemic side effects of levosimendan and dobutamine with integrated backscatter analysis.
MedLine Citation:
PMID:  19353707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Levosimendan improves cardiac contractility without increasing oxygen consumption. However, its effects on ischemia were not supported with the utilization of a noninvasive parameter of myocardial characterization. HYPOTHESIS: The changes observed in integrated backscatter (IBS) may be reflective of change in myocardial ischemia. In this study, the effect of levosimendan on ischemia detected by IBS was evaluated in patients with ischemic heart failure (HF). METHODS: Patients who had LVEF < 40% and NYHA III-IV symptoms of HF were included in this study. Patients were randomized to levosimendan (n = 21), or to dobutamine (n = 25) groups. The cyclic variation of integrated backscatter (CVIBS) was determined as the difference between the maximal and minimal values in a cardiac cycle, average of three consecutive beats. CVIBS was taken from the mid-anteroseptal, mid-inferior, and mid-posterolateral areas of the parasternal short axis images before the drug administration and at the end of the 24-hour infusion period. RESULTS: Baseline characteristics and concomitant medications were similar in both groups. A significant reduction in CVIBS was detected in anteroseptal (7.6 +/- 1.4 dB versus 5.9 +/- 0.8 dB, p = 0.01), inferior wall (7.4 +/- 0.8 dB versus 6.7 +/- 1.5 dB, p = 0.03), and posterolateral wall (9.0 +/- 1.2 dB versus 8.2 +/- 0.6 dB, p = 0.04) after dobutamine administration, while no significant changes were observed in the levosimendan group in all walls. CONCLUSIONS: Unlike dobutamine, levosimendan may not induce myocardial ischemia as shown by CVIBS at commonly used dosages in the setting of decompensated HF without active ischemia.
Authors:
Hamza Duygu; Sanem Nalbantgil; Mehdi Zoghi; Filiz Ozerkan; Ahmet Yildiz; Azem Akilli; Mustafa Akin
Related Documents :
12931107 - Relationship between dobutamine response of dyssynergic myocardium and angiographically...
15113007 - Improved interpretation of dobutamine stress echocardiography following 4 months of sys...
2187517 - Preoperative evaluation of cardiac risk using dobutamine-thallium imaging in vascular s...
10979027 - The role of stress echocardiography in children.
22160667 - Characterization of the failing murine heart in a desmin knock-out model using a clinic...
12834567 - Cardiac resynchronization therapy for advanced heart failure.
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical cardiology     Volume:  32     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-13     Completed Date:  2009-06-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  187-92     Citation Subset:  IM    
Affiliation:
Ege University Medical Faculty, Department of Cardiology, Izmir, Turkey. hamzakard@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cardiotonic Agents / administration & dosage,  adverse effects,  diagnostic use*
Dobutamine / administration & dosage,  adverse effects,  diagnostic use*
Electrocardiography / methods
Female
Humans
Hydrazones / administration & dosage,  adverse effects,  diagnostic use*
Image Interpretation, Computer-Assisted
Injections, Intravenous
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  radiography
Predictive Value of Tests
Pyridazines / administration & dosage,  adverse effects,  diagnostic use*
Stroke Volume
Treatment Outcome
Ventricular Function, Left / drug effects
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan; 34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Stem cells improve left ventricular function in acute myocardial infarction.
Next Document:  Effects of statins on endothelial function in patients with coronary artery disease.