Document Detail

Effects of levosimendan on left atrial functions in patients with ischemic heart failure.
MedLine Citation:
PMID:  19072879     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: With further progression of left ventricular (LV) dysfunction, the left atrial (LA) contribution to LV filling gradually decreases, and LA dysfunction deteriorates the decreased LV filling in patients with heart failure (HF). HYPOTHESIS: This study sought to investigate the effects of levosimendan on LA function in patients with HF. METHODS: A total of 60 patients having acute decompensated HF with ischemic cardiomyopathy and LV ejection fraction (LVEF) < 40% were included in the study. Patients were randomized to levosimendan (n = 30) or to dobutamine (n = 30). Before and 24 h after treatment, LVEF, mitral inflow peak E and A wave velocity, E/A ratio, mitral lateral annulus peak Em wave velocity, E/Em ratio, LA volumes, and from the LA volumes the active emptying fraction (AEF), passive emptying fraction (PEF), and reservoir fraction (RF) were measured. RESULTS: All LA volumes were significantly reduced after levosimendan administration, but in the dobutamine group only minimal volume (Vmin) was reduced. Although AEF increased in both groups, the improvement of AEF was greater in the levosimendan group than in the dobutamine group (14% +/- 9% versus 2% +/- 1%, p = 0.001). The PEF (12% +/- 8% versus 21% +/- 6%, p = 0.04) and RF (23% +/- 4% versus 38% +/- 3%, p = 0.001) significantly increased after levosimendan administration, whereas these parameters did not change after dobutamine. In patients receiving levosimendan, there was a significant, positive correlation between PEF and Em (r = 0.475, p = 0.008), and there were significant negative correlations between PEF and E/Em (r = - 0.491, p = 0.006), and AEF and E/Em (r = - 0.654, p = 0.001). CONCLUSIONS: Left atrial functions respond better to levosimendan than to dobutamine in decompensated HF.
Hamza Duygu; Sanem Nalbantgil; Filiz Ozerkan; Mehdi Zoghi; Azem Akilli; Umit Erturk; Mustafa Akin; Cem Nazli; Oktay Ergene
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Clinical cardiology     Volume:  31     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-25     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  607-13     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley Periodicals, Inc.
Department of Cardiology, Ege University Medical Faculty, Izmir, Turkey.
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MeSH Terms
Atrial Function, Left / drug effects*
Blood Pressure / drug effects
Cardiotonic Agents / pharmacology*
Dobutamine / pharmacology
Heart Failure / physiopathology*
Hydrazones / pharmacology*
Middle Aged
Myocardial Ischemia / physiopathology*
Pyridazines / pharmacology*
Stroke Volume / drug effects
Ventricular Function, Left / drug effects
Ventricular Pressure / drug effects
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

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