The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery
Background: Right ventricular (RV) dysfunction is an important predictor of both immediate and long-term outcomes in valve surgeries. Levosimendan has proven beneficial in improving RV function. Aims: The objective was to study the effect of the addition of levosimendan to the conventional treatment...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Annals of Cardiac Anaesthesia |
| Subjects: | |
| Online Access: | http://www.annals.in/article.asp?issn=0971-9784;year=2023;volume=26;issue=1;spage=50;epage=56;aulast=Bharathi |
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| author | K S Bharathi Gegal Pruthi Manasa Dhananjaya Parimala Prasanna Simha |
| author_facet | K S Bharathi Gegal Pruthi Manasa Dhananjaya Parimala Prasanna Simha |
| author_sort | K S Bharathi |
| collection | DOAJ |
| description | Background: Right ventricular (RV) dysfunction is an important predictor of both immediate and long-term outcomes in valve surgeries. Levosimendan has proven beneficial in improving RV function.
Aims: The objective was to study the effect of the addition of levosimendan to the conventional treatment on RV function in patients with RV dysfunction undergoing mitral valve (MV) surgeries.
Setting and Design: Prospective randomized double-blinded controlled study at a tertiary care institution.
Materials and Methods: Sixty adult patients aged 15–65 years, with preoperative transthoracic echocardiography (TTE) findings of RV dysfunction posted for elective MV surgery, were randomized into levosimendan (L) group and placebo (P) group. Patients in the L group were administered levosimendan at a rate of 0.1 mcg/kg/min after induction for 24 hrs, whereas patients in the P group were given multivitamin infusion at the same rate. Both the groups received standard inotropic therapy. The hemodynamic and echocardiographic parameters of RV function (RV size, Inferior vena cava (IVC) diameter, RV fractional area change (RVFAC) Tricuspid annular plane systolic excursion (TAPSE), and Systolic Pulmonary Artery Pressure (SPAP) were compared between the groups at 6 hrs, 24 hrs, and 7th day postoperatively.
Results: All hemodynamic and echocardiographic parameters of RV function like RV size, IVC diameter, RVFAC, TAPSE, and SPAP improved from baseline to 24 hrs in both groups. Levosimendan caused a significant improvement in RV function compared to the P group at 24 hrs and 7th day postoperatively.
Conclusions: The present study concludes that levosimendan is a promising option in patients with RV dysfunction undergoing MV surgeries. |
| first_indexed | 2024-04-10T09:57:26Z |
| format | Article |
| id | doaj.art-33c773f4971146c7804ef6e346dd74cf |
| institution | Directory Open Access Journal |
| issn | 0971-9784 |
| language | English |
| last_indexed | 2024-04-10T09:57:26Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Cardiac Anaesthesia |
| spelling | doaj.art-33c773f4971146c7804ef6e346dd74cf2023-02-16T12:00:25ZengWolters Kluwer Medknow PublicationsAnnals of Cardiac Anaesthesia0971-97842023-01-01261505610.4103/aca.aca_179_21The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgeryK S BharathiGegal PruthiManasa DhananjayaParimala Prasanna SimhaBackground: Right ventricular (RV) dysfunction is an important predictor of both immediate and long-term outcomes in valve surgeries. Levosimendan has proven beneficial in improving RV function. Aims: The objective was to study the effect of the addition of levosimendan to the conventional treatment on RV function in patients with RV dysfunction undergoing mitral valve (MV) surgeries. Setting and Design: Prospective randomized double-blinded controlled study at a tertiary care institution. Materials and Methods: Sixty adult patients aged 15–65 years, with preoperative transthoracic echocardiography (TTE) findings of RV dysfunction posted for elective MV surgery, were randomized into levosimendan (L) group and placebo (P) group. Patients in the L group were administered levosimendan at a rate of 0.1 mcg/kg/min after induction for 24 hrs, whereas patients in the P group were given multivitamin infusion at the same rate. Both the groups received standard inotropic therapy. The hemodynamic and echocardiographic parameters of RV function (RV size, Inferior vena cava (IVC) diameter, RV fractional area change (RVFAC) Tricuspid annular plane systolic excursion (TAPSE), and Systolic Pulmonary Artery Pressure (SPAP) were compared between the groups at 6 hrs, 24 hrs, and 7th day postoperatively. Results: All hemodynamic and echocardiographic parameters of RV function like RV size, IVC diameter, RVFAC, TAPSE, and SPAP improved from baseline to 24 hrs in both groups. Levosimendan caused a significant improvement in RV function compared to the P group at 24 hrs and 7th day postoperatively. Conclusions: The present study concludes that levosimendan is a promising option in patients with RV dysfunction undergoing MV surgeries.http://www.annals.in/article.asp?issn=0971-9784;year=2023;volume=26;issue=1;spage=50;epage=56;aulast=Bharathiinodilatorlevosimendanmitral valve surgeryright ventricular dysfunctiontransesophageal echocardiographytransthoracic echocardiography |
| spellingShingle | K S Bharathi Gegal Pruthi Manasa Dhananjaya Parimala Prasanna Simha The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery Annals of Cardiac Anaesthesia inodilator levosimendan mitral valve surgery right ventricular dysfunction transesophageal echocardiography transthoracic echocardiography |
| title | The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery |
| title_full | The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery |
| title_fullStr | The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery |
| title_full_unstemmed | The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery |
| title_short | The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery |
| title_sort | effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery |
| topic | inodilator levosimendan mitral valve surgery right ventricular dysfunction transesophageal echocardiography transthoracic echocardiography |
| url | http://www.annals.in/article.asp?issn=0971-9784;year=2023;volume=26;issue=1;spage=50;epage=56;aulast=Bharathi |
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