Document Detail


Levosimendan allows detection of contractile reserve in patients with chronic ischaemic left ventricular dysfunction and non-diagnostic dobutamine echocardiography.
MedLine Citation:
PMID:  17572145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dobutamine echocardiography is commonly used to detect contractile reserve in ischaemic left ventricular (LV) systolic dysfunction, although its sensitivity and specificity are not optimal. We tested the hypothesis that echocardiography with levosimendan could identify contractile reserve in patients with a non-diagnostic dobutamine test.
METHODS: Twenty-two patients with LV ejection fraction <40% and non-diagnostic dobutamine echocardiography underwent levosimendan challenge (24 microg/kg in 10 min) prior to coronary angioplasty or surgery.
RESULTS: Contractile reserve was identified by levosimendan in 10 patients (Gr. A) but was not seen in 12 patients (Gr. B). With levosimendan, LV ejection fraction increased and wall motion score index decreased significantly in Gr. A, but only slightly in Gr. B. Similarly, mean mitral annular plane excursion and peak systolic mitral annular motion velocity increased significantly in Gr. A only. Six months after revascularisation, contractile reserve was seen in 8/10 Gr. A patients but in only 2/12 Gr. B patients (80% vs 17%, p=0.011). LV ejection fraction, wall motion score index, mean mitral annular plane excursion and peak systolic mitral annular motion velocity were significantly higher in Gr. A than in Gr. B.
CONCLUSION: Levosimendan echocardiography can identify contractile reserve in a sizeable proportion of patients with chronic ischaemic LV dysfunction and a non-diagnostic dobutamine test.
Authors:
Cinzia Cianfrocca; Francesco Pelliccia; Antonio Auriti; Vincenzo Guido; Vincenzo Pasceri; Xue Li; Giuseppe Richichi; Giuseppe Mercuro; Massimo Santini
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-06-14
Journal Detail:
Title:  European journal of heart failure     Volume:  9     ISSN:  1388-9842     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-09-03     Completed Date:  2007-11-13     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  897-900     Citation Subset:  IM    
Affiliation:
Department of Cardiology, San Filippo Neri Hospital, Rome, Italy. c.cianfrocca@mclink.it
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MeSH Terms
Descriptor/Qualifier:
Cardiotonic Agents / diagnostic use*
Dobutamine / diagnostic use
Echocardiography / methods*
Humans
Hydrazones / diagnostic use*
Myocardial Contraction
Myocardial Ischemia / complications
Pyridazines / diagnostic use*
Ventricular Dysfunction, Left / etiology,  ultrasonography*
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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