The effect of levosimendan and dobutamine treatment on QT dispersion in patients with decompensated heart failure: a prospective study

Paksoy, Fatma; Ulaş, Turgay; Tursun, İrfan; Dal, Mehmet Sinan; Öztekin, Erkan; Borlu, Fatih

doi:10.5152/akd.2012.004

Cited by 3 publications

(5 citation statements)

References 23 publications

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“…Because; the QT and Tp-e parameters did not significantly change with levosimendan infusion in the inotropic and without inotropic treatment group. Paksoy et al [16] investigated the effect of intravenous levosimendan and dobutamine on QT parameters and found that levosimendan and dobutamine did not have a significant effect on QT parameters (16). In our study group we used dopamine/dobutamine and levosimendan concomitant at inotropic therapy.…”

Section: Discussionmentioning

confidence: 97%

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The effect of levosimendan on Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio and QRS interval in heart failure patients

Aktaş

Karakuş

Çamcı

et al. 2017

The European Research Journal

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Objectives. Increased Tp-e interval (from the peak-to-the-end of the electrocardiographic T wave) and Tpe/QT ratio are associated with malignant ventricular arrhythmias. We aimed to evaluate the acute effects of levosimendan on Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio and QRS interval in patients with severe heart failure. Methods. The study included 85 patients with decompansed heart failure, who were treated with levosimendan in our cardiology department . We evaluated the patients retrospectively. QT and Tp-e interval were assessed in the precordial leads. QRS duration was determined in the single lead which had the longest QRS. Electrocardiographic measurements was performed the basal (just before the levosimendan) and 24 th hour after the levosimendan infusion (just after the levosimendan infusion). Results. No significant differences were found between before and after treatment of levosimendan with respect to Tp-e and QTc interval, QRS duration, Tp-e/QT and Tp-e/QTc ratio (pretreatment versus 24 th hour values; p>0.05). Subgroup analysis was performed in the patients with inotropic therapy including dopamine and/or dobutamin (34 patients) and without inotropic therapy (49 patients) during the levosimendan infusion. The analysis showed that pretreatment and 24th hour values of Tp-e interval and Tp-e/QT ratio were significantly higher in the inotropic therapy group; (Pretreatment; Tp-e: 100.12±22.96 milliseconds [ms] versus 89.59±17.67 ms; p=0.03, Tp-e/QT: 0.26±0.05 versus 0.23±0.04; p=0.007, 24th hour: Tp-e: 101.41±27.09 ms versus 88.77±15.89 ms; p=0.009, Tp-e/QT: 0.26±0.07 versus 0.23±0.05; p=0.03). However intra-group changes of these parameters, before and after levosimendan treatment , were not significant (p>0.05). Conclusion. Our results suggested that, therapeutic doses of levosimendan infusion don't have a significant effect on Tp-e and Tp-e/QT parameters. However inotropic therapy significantly increases these parameters.Eur Res J 2017;3(3):220-226

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Section: Discussionmentioning

confidence: 97%

“…In our study group we used dopamine/dobutamine and levosimendan concomitant at inotropic therapy. However, Paksoy et al [16] prolongation is usually associated with cardiac ischemia. QT is not affected by inotropic therapy unless patients have cardiac ischemia.…”

Section: Discussionmentioning

confidence: 99%

The effect of levosimendan on Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio and QRS interval in heart failure patients

Aktaş

Karakuş

Çamcı

et al. 2017

The European Research Journal

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“…In the present study, probably keeping electrolyte balance within normal limits prevented the development of lethal arrhythmias. In our recently published study, therapeutic doses of levosimendan did not have a significant effect on QT parameters the predictors of arrhythmias, in patients with decompensated HF when compared with dobutamine infusion (22) .…”

Section: Discussionmentioning

confidence: 99%

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

Tursun¹,

Gürsoy²,

Ulaş³

et al. 2014

Khj

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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.

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“…Increased QTc and/or QTd are known to be the cause of ventricular arrhythmia in various systemic diseases and lead to an increase in mortality and morbidity. Increased QTd has been shown to be an important prognostic factor in several cardiovascular conditions such as coronary artery disease, congestive heart failure and cardiomyopathy (21,32). Literature reviews found the QTd to vary mostly between 30 and 60 msec in normal subjects, although average values around 70 msec were also reported (33).…”

Section: Comparison Of Pd Qtd and Hr Values Between Gs And Control Gmentioning

confidence: 99%

“…Measurements were not taken in derivations if the end of T wave was not determined or the amplitude was low. QTd is defined as the difference between QTmax and QTmin (21). The intervals of QT were corrected according to heart rate (HR) using the Bazett formula "Corrected QT interval (QTc)=QT/ √R-R" and expressed as QTc.…”

Section: Diagnosis Of Gsmentioning

confidence: 99%

The effect of Gilbert’s syndrome on the dispersions of QT and P-wave dispersion: an observational study

Cüre¹,

Yüce²,

Çiçek³

et al. 2013

Anadolu Kardiyol Derg

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Objective: Gilbert's syndrome (GS) decreases the incidence of atherosclerotic heart disease. The aim of the study was to evaluate whether the arrhythmia risk markers such as P-wave dispersion (Pd), QT dispersion (QTd) are reduced in patients with GS compared with healthy subjects. Methods: Sixty-one patients diagnosed with GS (31 females, 30 males) who had applied to the internal medicine outpatient clinic in the hospital were included in this cross-sectional, observational study. A control group of 61 healthy persons (31 females, 30 males), who were non-smokers and drinkers, were included. Both groups were between 16-45 years old. Results of anthropometric measurements, laboratory assays and electrocardiographic findings were recorded for each participant. Independent sample t-test and nested ANOVA were used for data analysis. Results: In the GS group were Pd value 36±16.7 msec, QTd 48.7±10.7 msec and heart rate (HR) 74±8 beat/min. In the control group were Pd 51±28 msec, QTd 53±12 msec and HR 78±10 beat/min. The Pd of patients group (p<0.001), QTd (p=0.038) and HR (p=0.021) were significantly lower than the control group. Conclusion: According to our study's results, in these patients, increased bilirubin levels are associated with decrease in HR, Pd and QTd, which consequently might decrease the incidence of cardiac arrhythmias and coronary artery disease. Further studies are needed to clarify the protective role of bilirubin in risk of arrhythmias in this category of patients. (

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The effect of levosimendan and dobutamine treatment on QT dispersion in patients with decompensated heart failure: a prospective study

Cited by 3 publications

References 23 publications

The effect of levosimendan on Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio and QRS interval in heart failure patients

The effect of levosimendan on Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio and QRS interval in heart failure patients

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

The effect of Gilbert’s syndrome on the dispersions of QT and P-wave dispersion: an observational study

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