Efficacy of levosimendan vs dopamine in patients with resistant cardiac failure


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Aim. Effects of levosimendan treatment compared to dopamine treatment on a clinical course, central hemodynamics and prognosis in patients with resistant cardiac failure (RCF).
Material and methods. A total of 30 RCF patients (16 females and 14 males aged 50-80 years) were divided into two groups. Patients of group 1 received inotropic drug levosimendan intravenously in the initial dose 12-24 mcg/kg for 10 min with subsequent 24-hour infusion in a dose 0.1 mcg/kg/min. Patients of group 2 received dopamine intravenously for 24 hours in a mean dose 2.2 mcg/kg/min. The patients were followed up for 6 months.
Results. In group 1 cardiac failure regressed earlier than in group 2. Left ventricular performance index after infusion hour 1 increased from 2.9 to 3.3 (kg.m)/m2, in group 2 it decreased from 2.6 to 2.3 (kg.m)/m2; p = 0.028). To infusion hour 24 this index in group 1 was 3.2 (kg.m)/m2, in group 2 - 2.6 (kg.m)/m2. Cardiac index (CI) in group 1 increased from 2.3 l/min/m2 at infusion min 1 to 2.7 l/min/ m2 after 10 min of infusion and 2.9 l/min/m2 after 24 hours, i.e. there was a 26% rise (p = 0.025). In group 2 the CI rise was insignificant - from 2.4 to 2.5 l/min/m2. To the end of levosimendan injection, systemic vascular resistance fell from 1520.9 to 1174.6 dyne.s.cm-5 (p = 0.031), in group 2 no significant changes were seen. Hospital mortality in group 1 was 1 patient, in group 2 - 6 patients.
Conclusion. Inotropic treatment in RCF patients with levosimendan vs dopamine produces earlier regress of cardiac failure symptoms, better improvement of myocardial contractivity, is associated with a good prognosis.

作者简介

Nino Dzhaiani

Email: doctorni@yandex.ru

Irina Kositsyna

Email: voshlik@rambler.ru

Natal'ya Gnidkina

Email: hmorel@rambler.ru

Sergey Tereshchenko

Email: stereschenko@yandex.ru

N Dzhaiani

Medico-Stomatological University, Moscow

Medico-Stomatological University, Moscow

I Kositsyna

Medico-Stomatological University, Moscow

Medico-Stomatological University, Moscow

N Gnidkina

Medico-Stomatological University, Moscow

Medico-Stomatological University, Moscow

S Tereschenko

Medico-Stomatological University, Moscow;Russian Cardiological Research Center, Moscow

Medico-Stomatological University, Moscow;Russian Cardiological Research Center, Moscow

参考

  1. Беленков Ю. Н., Мареев В. Ю., Агеев Ф. Т., Даниелян М. О. Первые результаты национального эпидемиологического исследования -эпидемиологическое обследование больных ХСН в реальной практике (по обращаемости) - ЭПОХА-О-ХСН. Серд. недостат. 2003; 3: 116-120.
  2. Национальные рекомендации ВНОК и ОССН по диагностике и лечению ХСН (третий пересмотр). Серд. недостат. 2010; 11 (1).
  3. Adams K. F., Fonarow G. C., Emerman C. L. et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). Am. Heart J. 2005; 149: 209-216.
  4. Ellison D. H. Diuretic therapy and resistance in congestive heart failure . Cardiology 2001; 96: 132-143.
  5. Cleland J. G., Coletta A. P., Nikitin N. P. et al. Clinical trials update from the American College of Cardiology: Darbepoetin alfa, ASTEROID, UNIVERSE, paediatric carvedilol, UNLOAD and ICELAND. Eur. J. Heart Fail. 2006; 8 (3): 326- 329.
  6. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Eur. Heart J. 2008; 29: 2388-2442.
  7. Пархисенко Ю. А., Булынин А. В., Кустовинов М. А. и др. Механические системы вспомогательной поддержки кровообращения. Хирургия 2006; 2: 42-45.
  8. Follath F., Cleland J. G., Just H. et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomized double-blind trial. Lancet 2002; 360: 196-202.
  9. Zairis M. N., Apostolatos C., Anastassiadis F. et al. Comparison of the effect of levosimendan, or dobutamine or placebo in chronic low output decompensated heart failure. Calcium Sensitizer or Inotrope or NOne in low output heart failure (CASINO) study. In: Program and abstracts of the European Society of Cardiology, Heart Failure Update 2004; June 12-15, 2004; Wroclaw; 2004. Abstr. 273.
  10. Teerlink J. R., Delgado-Herrera L., Thakkar R. et al. Clinical composite endpoint classification of REVIVE II corresponds to all-cause mortality risk. Eur. J. Heart Fail. Suppl. 2007; 6 (1): 106.
  11. Silva-Cardoso J., Ferreira J., Oliveira-Soares A. et al. PORTLAND Investigators. Effectiveness and safety of levosimendan in clinical practice. Rev. Port. Cardiol. 2009; 28 (2): 143-154.
  12. Mebazaa A., Nieminen M., Packer M. et al. Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. J. A. M. A. 2007; 297 (17): 1883-1891.
  13. Cohen-Solal A., Logeart D., Huang B. et al. Lowered B-type natriuretic peptide in response to levosimendan or dobutamine treatment is associated with improved survival in patients with severe acutely decompensated heart failure. J. Am. Coll. Cardiol. 2009; 53 (25): 2343-2348.
  14. Packer M., Colucci W. S., Fisher L. Development of a comprehensive new endpoint for the evaluation of new treatments for acute decompensated heart failure: results with levosimendan in the REVIVE study. (Abstract). J. Card. Fail. 2003; 9: S61.
  15. Packer M. REVIVE II: Multicenter placebo-controlled trial of levosimendan on clinical status in acutely decompensated heart failure. In: Program and abstracts from the American Heart Association scientific sessions 2005; November 13-16, 2005; Dallas, Texas. Late Breaking Clinical Trials II. Dallas; 2005.
  16. Kivikko M., Antila S., Eha J. et al. Pharmacokinetics of levosimendan and its metabolites during and after a 24-hour continuous infusion in patients with severe heart failure. Int. J. Clin. Pharmacol. Ther. 2002; 40 (10): 465-471.
  17. Sandell E.-P., Aalto T., Antila S. et al. The effects of severe congestive heart failure on the pharmacokinetics of levosimendan. Eur. J. Clin. Pharmacol. 1997; 52 (Suppl.): 55.
  18. Colucci W. S., Slawsky M. T., Koivikko M. Prolonged effects of a 24-hour infusion of the calcium sensitiser levosimendan in patients with severe heart failure. Eur. J. Heart Fail. 2002; 1 (Suppl.): 80.
  19. Gruhn N., Nielsen-Kudsk I. E., Theilgaard S. et al. Coronary vas-orelaxant effect of levosimendan, a new modulator with calcium-sensitizing properties. J. Cardiovasc. Pharmacol. 1998; 31: 741-749.
  20. Метелица В. И. Справочник по клинической фармакологии сердечно-сосудистых лекарственных средств. 3-е изд. М.: Мед. информ. изд-во; 2005. 1234-1235.
  21. Старкова Г. В. Нарушение функции почек и возможности ее медикаментозной коррекции у больных хронической сердечной недостаточностью в раннем постинфарктном периоде: Дис. ... канд. мед. наук. Волгоград; 2004.
  22. Терещенко С. Н., Демидова И. В. Почечная функция при хронической сердечной недостаточности у больных пожилого и старческого возраста. Сердце 2001; 1 (5): 251-256.
  23. Fonarow G. C., Stough W. G., Abraham W. T. et al. for the OPTIMIZE-HF Investigators and Hospitals. Characteristics, treatments, and outcomes of patients with preserved systolic function hospitalized for heart failure. A report from the OPTIMIZE-HF Registry. J. Am. Coll. Cardiol. 2007; 50: 768- 777.

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