Efficiency of Levosimendan therapy in heart failure: Is it efficient on patients with cardiac dyssynchrony?

Buyuklu, Mutlu; Set, Turan; Tatlı, Ersan; Barutcu, Ahmet; Aksu, Feyza
August 2012
HealthMed;2012, Vol. 6 Issue 4, p1356
Academic Journal
Aim: Levosimendan is a new inotropic drug used in acute heart failure for its cardiac contractility increasing effect without increasing myocar-dial oxygen consumption. Longer QRS duration is an important prognostic indicator independent of the underlying heart disease. In heart failure, presence of a QRS duration ≥ 120ms is regarded as an indicator of cardiac dyssynchrony. In our study, we investigated the efficiency of levosimendan in cardiac dyssynchrony patients whose QRS duration in ECG is accepted ≥ 120ms. Methods: Fifty-one acute heart failure patients with left ventricular systolic dysfunction were accepted into the study. Patients were divided into two groups as those with QRS duration ≥ 120ms to the study group and QRS duration ≤ 120ms to the control group, based on surface ECG. Levosimendan therapy was administered to both groups in addition to standard therapy for a duration of 24 hours. Serum MMP-9 and TIMP-1 levels of two groups observed in blood samples taken before and after the therapy were compared. Results: There is no significant difference between the datum (preliminary) levels of serum MMP-9 and TIMP-1 in both groups. However, serum MMP-9 level is higher and serum TIMP-1 level was lower in the study group. While serum MMP-9 level significantly degraded in the study group after therapy, increase in serum TIMP-1 level did not reached a significant value (p=0.036, p=0.053). When we compared the differences between before and after therapy levels, no significant difference was observed between the two groups. Conclusion: For heart failure patients with estimated left ventricular dyssynchrony according to surface ECG, levosimendan therapy is as efficient as it is with patients without dyssynchrony. For patients with high preliminary (initial) neurohu-moral indicator levels, this therapy also effectively decreases these values.


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