open access

Vol 22, No 1 (2015)
Original articles
Published online: 2015-02-24
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Assessment of sustained effects of levosimendan and dobutamine on left ventricular systolic functions by using novel tissue Doppler derived indices in patients with advanced heart failure

Ender Oner, Mehmet Erturk, Ali Birant, Aslı Kurtar Mansıroglu, Ibrahim Faruk Akturk, Huseyin Karakurt, Ahmet Arif Yalcin, Fatih Uzun, Mustafa Umut Somuncu, Aydin Yildirim
DOI: 10.5603/CJ.a2014.0044
·
Pubmed: 24846511
·
Cardiol J 2015;22(1):87-93.

open access

Vol 22, No 1 (2015)
Original articles
Published online: 2015-02-24

Abstract

Background: Previous studies comparing levosimendan vs. dobutamine have revealed that levosimendan is better in relieving symptoms. Echocardiographic studies have been done using second measurements immediately following a dobutamine infusion or while it was still being administered. The aim of our study was assessment of sustained effects of 24 h levosimendan and dobutamine infusions on left ventricular systolic functions.

Methods: A total of 61 patients with acutely decompensated heart failure with New York Heart Association (NYHA) class III or IV symptoms were randomized to receive either levosimendan or dobutamine 2:1 in an open label fashion. Before and 5 days after the initiation of infusions, functional class was assessed, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels and left ventricular ejection fraction (LVEF), mitral inflow peak E and A wave velocity, and E/A ratios were measured; using tissue Doppler imaging, isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), early (E’) and late (A’) diastolic velocities, and E’/A’ and E/E’ ratios were measured.

Results: The NYHA class improved in both groups, but improvements were prominent in the levosimendan group. NT-proBNP levels were significantly reduced in the levosimendan group. Improvements in LVEF and diastolic indices were significant in the levosimendan group. Tissue Doppler-derived systolic indices of IVV and IVA increased significantly in the levosimendan group.

Conclusions: Improvements in left ventricular systolic and diastolic functions continue after a levosimendan infusion.

Abstract

Background: Previous studies comparing levosimendan vs. dobutamine have revealed that levosimendan is better in relieving symptoms. Echocardiographic studies have been done using second measurements immediately following a dobutamine infusion or while it was still being administered. The aim of our study was assessment of sustained effects of 24 h levosimendan and dobutamine infusions on left ventricular systolic functions.

Methods: A total of 61 patients with acutely decompensated heart failure with New York Heart Association (NYHA) class III or IV symptoms were randomized to receive either levosimendan or dobutamine 2:1 in an open label fashion. Before and 5 days after the initiation of infusions, functional class was assessed, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels and left ventricular ejection fraction (LVEF), mitral inflow peak E and A wave velocity, and E/A ratios were measured; using tissue Doppler imaging, isovolumic myocardial acceleration (IVA), peak myocardial velocity during isovolumic contraction (IVV), peak systolic velocity during ejection period (Sa), early (E’) and late (A’) diastolic velocities, and E’/A’ and E/E’ ratios were measured.

Results: The NYHA class improved in both groups, but improvements were prominent in the levosimendan group. NT-proBNP levels were significantly reduced in the levosimendan group. Improvements in LVEF and diastolic indices were significant in the levosimendan group. Tissue Doppler-derived systolic indices of IVV and IVA increased significantly in the levosimendan group.

Conclusions: Improvements in left ventricular systolic and diastolic functions continue after a levosimendan infusion.

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Keywords

levosimendan, dobutamine, acute heart failure, isovolumic acceleration

About this article
Title

Assessment of sustained effects of levosimendan and dobutamine on left ventricular systolic functions by using novel tissue Doppler derived indices in patients with advanced heart failure

Journal

Cardiology Journal

Issue

Vol 22, No 1 (2015)

Pages

87-93

Published online

2015-02-24

DOI

10.5603/CJ.a2014.0044

Pubmed

24846511

Bibliographic record

Cardiol J 2015;22(1):87-93.

Keywords

levosimendan
dobutamine
acute heart failure
isovolumic acceleration

Authors

Ender Oner
Mehmet Erturk
Ali Birant
Aslı Kurtar Mansıroglu
Ibrahim Faruk Akturk
Huseyin Karakurt
Ahmet Arif Yalcin
Fatih Uzun
Mustafa Umut Somuncu
Aydin Yildirim

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