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Eremenko A.A.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Fominykh M.V.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Kolpakov P.E.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Babaev M.A.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Fedulova S.V.

Rossiĭskiĭ nauchnyĭ tsentr khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

Levosimendan in evaluation of myocardial reserves in cardiosurgical patients with heart failure

Authors:

Eremenko A.A., Fominykh M.V., Kolpakov P.E., Babaev M.A., Fedulova S.V.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2013;6(1): 81‑84

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To cite this article:

Eremenko AA, Fominykh MV, Kolpakov PE, Babaev MA, Fedulova SV. Levosimendan in evaluation of myocardial reserves in cardiosurgical patients with heart failure. Russian Journal of Cardiology and Cardiovascular Surgery. 2013;6(1):81‑84. (In Russ.)

 
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Evaluation of alterations in hemodynamic indices and brain natriuretic peptide (BNP) concentration was carried in response to levosimendan infusion. 77 patients with chronic heart failure were included in the study. Levosimendan (Simdax, Orion Pharma) showed statistically significant increase in ejection fraction, stroke and end systolic left ventricular volume, decreased pulmonary arterial pressure and BNP concentration. According to results of drug administration patients can be divided into groups depending on different response to therapy. Good effect of the drug in dynamics of pulmonary arterial pressure, ejection fraction and BNP concentration was observed accordingly in 14.5%, 13.4% and 7.6% of patients. Moderate alterations of these parameters were observed accordingly in 79, 64.2 and 45.5% of patients. Accordingly in 6.5, 22.4 and 47 % of patients parameters didn't virtually change. It is shown that dynamics in pulmonary arterial pressure best reflects the direct effect of the drug. More significant effect of the drug in patients with moderate heart failure recommends earlier start of treatment. Levosimendan can be used as a pharmacologic test allowing estimating the prognosis and surgical tactics.

Keywords:

chronic heart failure
levosimendan
hemodynamics
prognosis

Authors:

Eremenko A.A.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Fominykh M.V.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Kolpakov P.E.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Babaev M.A.

Otdelenie kardioreanimatsii i intensivnoĭ terapii FGBU RNTsKh im. akad. B.V. Petrovskogo RAMN, Moskva

Fedulova S.V.

Rossiĭskiĭ nauchnyĭ tsentr khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

List of references:

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  2. Branzi G., Malfatto G., Villani A. et al. Acute effects of levosimendan on mitral regurgitation and diastolic function in patients with advanced chronic heart failure. J Cardiovasc Med (Hagerstown) 2010; 11: 9: 662-668.
  3. Farmakis D., Parissis J.T., Bistola V. et al. Plasma B-type natriuretic peptide reduction predicts long-term response to levosimendan therapy in acutely decompensated chronic heart failure. Int J Cardiol 2010; 18: 139: 1: 75-79.
  4. Follath F., Cleland J.G., Just H. et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe lowoutput heart failure (the LIDO study): A randomised double-blind trial. Lancet 2002; 360: 196-202.
  5. Giannakoulas G., Giannoglou G., Vassilikos V. et al. Clinical significance of acute neurohormonal response after levosimendan treatment. Am J Cardiol 2006; 98: 1123-1124.
  6. Giglioli C., Cecchi E., Landi D. et al. Levosimendan produces an additional clinical and hemodynamic benefit in patients with decompensated heart failure successfully submitted to a fluid removal treatment. Congest Heart Fail 2012; 18: 1: 47-53.
  7. Landoni G., Biondi-Zoccai G., Greco M. et al. Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. Crit Care Med 2012; 40: 2: 634-646.
  8. Lunghetti S., Palmerini E., Urselli R. et al. Effects of levosimendan without loading dose on systolic and diastolic function in patients with end-stage heart failure. Cardiol J 2011; 18: 5: 532-537.
  9. Mebazaa A., Nieminen M.S., Packer M. et al. Levosimendan vs dobutamine for patients with acute decompensated heart failure: The SURVIVE Randomized Trial. JAMA 2007; 297: 1883-1891.
  10. Michaels A.D., McKeown B., Kostal M. et al. Effects of intravenous levosimendan on human coronary vasomotor regulation, left ventricular wall stress, and myocardial oxygen uptake. Circulation 2005; 111: 12: 1504-1509.
  11. Moiseyev V.S., Poder P., Andrejevs N. et al. Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebocontrolled, double-blind study (RUSSLAN). Eur Heart J 2002; 23: 1422-1432.
  12. Packer M. Revive II Trial Investigators: REVIVE II: Multicenter placebo-controlled trial of levosimendan on clinical status in acutely decompensated heart failure. Circulation 2005; 112: 3363.
  13. Papp Z., Csapo K., Pollesello P. et al. Pharmacological mechanisms contributing to the clinical efficacy of levosimendan. Cardiovasc Drug Rev 2005; 23: 71-98.
  14. Parissis J.T., Farmakis D., Bistola V. et al. Levosimendan for the treatment of acute heart failure syndromes: time to identify subpopulationsof responding patients. Am J Cardiol 2007; 99: 1: 146-147.
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