Levosimendan Optimal Medikal Tedavi Alan Dekompanse Kalp Yetersizliği Hastalarında NTproBNP Seviyesini ve Ekokardiyografik Parametreleri Düzeltir

Abstract

The effect of levosimendan on NT-proBNP levels and echocardiographic parameters in patients with decompensated heart failure receiving optimal medical therapy was evaluated. Patients and Methods:The study included 30 patients with acute heart failure with New York Heart Association (NYHA) class IV. Although all patients had received standard heart failure therapy, they required support of an inotropic agent. They received bolus and maintenance infusion of levosimendan treatment for 24 hours. Echocardiography was performed before the levosimendan treatment and at the 5 th day after the treatment. NT-proBNP levels were taken at 48 th hour and 5 th day. Results: Levosimendan treatment (bolus+maintenance infusion) was performed in all patients without any interruption or complication. A significant reduction in NT-proBNP levels was observed at the end of 48 th hour and 5 th day compared to baseline values (p<0.001). After the treatment, a significant improvement was observed in NYHA functional class. Significant improvement was observed in both systolic and diastolic echocardiographic parameters including ejection fraction (p<0.001), S' wave (p=0.03), E/A ratio (p<0.01), deceleration time of E wave (p<0.01), TDI S' (p<0.01), E' (p<0.01), and A' waves (p<0.01), and E/E' ratio (p<0.01). When the study was grouped into ischemic and nonischemic origin, no significant differences were observed regarding the clinical and echocardiographic parameters. No malignant arrhythmia was observed. Conclusion:Levosimendan may be safely used in normotensive patients with decompensated heart failure receiving optimal medical therapy. It provides an additional improvement in NT-proBNP levels and echocardiographic parameters.