Document Detail


Effects of levosimendan versus dobutamine on left atrial function in decompensated heart failure.
MedLine Citation:
PMID:  19812809     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although the effects of levosimendan on the left ventricle (LV) have been studied, its effect on left atrial (LA) function is poorly understood, despite its key role in optimizing LV function. OBJECTIVE: To compare the effects of levosimendan and dobutamine on LA and LV function in patients with decompensated heart failure (DHF). METHODS: Seventy-four patients (mean [+/- SD] age 64+/-10 years) with DHF and an LV ejection fraction of 35% or lower were randomly assigned to receive levosimendan (n=37) or dobutamine (n=37). LA active emptying fraction, LA passive emptying fraction (PEF) and the ratio of mitral inflow early diastolic velocity to annulus velocity (E/e) were evaluated with pulsed wave and tissue Doppler imaging along with plasma B-type natriuretic peptide (BNP) level measurements before and after drug infusion. RESULTS: The ejection fraction was significantly increased in both groups. The levosimendan group had a greater decrease in BNP and a greater increase in active emptying fraction at 24 h compared with the dobutamine group. The PEF, E/e and deceleration time of the E wave were significantly improved in the levosimendan group, but not in the dobutamine group. Levosimendan- induced percentage change of BNP was significantly correlated with the percentage change of E/e and PEF (r=0.48 [P<0.005] and r=-0.38 [P<0.05], respectively). CONCLUSIONS: In patients with DHF, levosimendan and dobutamine both improve LV systolic function. However, levosimendan also improves LV diastolic function and LA performance in parallel with a greater improvement in neurohormonal activation compared with dobutamine.
Authors:
Duman Duman; Fatih Palit; Ergun Simsek; Karadag Bilgehan; Atalay Sacide
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  25     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-08     Completed Date:  2009-10-27     Revised Date:  2010-10-04    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e353-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey. drduman@excite.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atrial Function, Left / drug effects*,  physiology
Cardiotonic Agents / administration & dosage,  therapeutic use*
Dobutamine / administration & dosage,  therapeutic use*
Dose-Response Relationship, Drug
Echocardiography
Electrocardiography
Female
Follow-Up Studies
Heart Failure / drug therapy*,  physiopathology,  ultrasonography
Humans
Hydrazones / administration & dosage,  therapeutic use*
Infusions, Intravenous
Male
Middle Aged
Prospective Studies
Pyridazines / administration & dosage,  therapeutic use*
Single-Blind Method
Treatment Outcome
Young Adult
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


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