LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILURE

Aim. To evaluate the efficacy of action of the calcium sensitizer levosimendan (LS) in patients with various grade of heart failure (HF) severity before cardiosurgery.Material and methods. LS was applied as a part of HF treatment while preparing patients for surgery in 2-4 days. Performed dose was 0...

Full description

Bibliographic Details
Main Authors: M. A. Babaev, A. A. Eremenko, O. V. Dymova, P. V. Polyakova, S. V. Fedulova, Yu. V. Frolova
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2017-03-01
Series:Российский кардиологический журнал
Subjects:
Online Access:https://russjcardiol.elpub.ru/jour/article/view/1598
_version_ 1797856896127860736
author M. A. Babaev
A. A. Eremenko
O. V. Dymova
P. V. Polyakova
S. V. Fedulova
Yu. V. Frolova
author_facet M. A. Babaev
A. A. Eremenko
O. V. Dymova
P. V. Polyakova
S. V. Fedulova
Yu. V. Frolova
author_sort M. A. Babaev
collection DOAJ
description Aim. To evaluate the efficacy of action of the calcium sensitizer levosimendan (LS) in patients with various grade of heart failure (HF) severity before cardiosurgery.Material and methods. LS was applied as a part of HF treatment while preparing patients for surgery in 2-4 days. Performed dose was 0,025 — 0,1 µg/kg/min. The drug was not administered  in bolus. Preoperation group of participants  included 108 patients (62% — men, 38% — women, aged 20 — 72 years (53±13)) with CHF III-IV  FC by NYHA,  with ejection  fraction  of the  left ventricle  (LVEF)  about  in average  27±8%.Mean  level of natriuretic  B-type  peptide  was  1129  (Me 854, Q25 396, Q75 1419) pg/mL. Main etiology of chronic HF in participants  was dilation  cardiomyopathy:  noncoronary  cardiomyopathy  in 30 patients  (27,7%), ischemic cardiomyopathy  (ischemic  heart  disease, postinfarction  cardiosclerosis) in 72 patients (66,7%) and acquired valve defects  in 6 patients (5,6%). For assessment of efficacy of the drug in various grade  of HF severity, patients  were selected to subgroups according  to the level of LVEF decrease (less 20%, 21-30%, 31-40%, more 40%), and pulmonary artery pressure (PAWP) (less 40 mmHg, 40-70 mmHg, more 70 mmHg).Results. Infusion of the drug led to statistically significant increase of LVEF comparing to the baseline (57%), decrease of PAWP (64%) and BNP concentration in 77% cases. Conclusion. The LS is an effective medication which can be applied with the aims to prepare HF patients to cardiosurgical operations. Most sensitive parameters of LS efficacy are PAWP, LVEF and BNP concentration. The highest efficacy of the drug was observed  in subgroup  with EF ≤40%, PAWP ≥40 mmHg and BNP ≥600 pg/mL. LS, applied in HF patients  before  cardiosurgery, can  be  used  for assessment of reserves  of myocardial capacity.
first_indexed 2024-04-09T20:49:03Z
format Article
id doaj.art-95e5f094818e43f5af4aab55267427cf
institution Directory Open Access Journal
issn 1560-4071
2618-7620
language Russian
last_indexed 2024-04-09T20:49:03Z
publishDate 2017-03-01
publisher «FIRMA «SILICEA» LLC
record_format Article
series Российский кардиологический журнал
spelling doaj.art-95e5f094818e43f5af4aab55267427cf2023-03-29T21:23:27Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202017-03-0103596210.15829/1560-4071-2017-3-59-621381LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILUREM. A. Babaev0A. A. Eremenko1O. V. Dymova2P. V. Polyakova3S. V. Fedulova4Yu. V. Frolova5V. B. Petrovskiy Russian National Research Centre of SurgeryV. B. Petrovskiy Russian National Research Centre of SurgeryV. B. Petrovskiy Russian National Research Centre of SurgeryV. B. Petrovskiy Russian National Research Centre of SurgeryV. B. Petrovskiy Russian National Research Centre of SurgeryV. B. Petrovskiy Russian National Research Centre of SurgeryAim. To evaluate the efficacy of action of the calcium sensitizer levosimendan (LS) in patients with various grade of heart failure (HF) severity before cardiosurgery.Material and methods. LS was applied as a part of HF treatment while preparing patients for surgery in 2-4 days. Performed dose was 0,025 — 0,1 µg/kg/min. The drug was not administered  in bolus. Preoperation group of participants  included 108 patients (62% — men, 38% — women, aged 20 — 72 years (53±13)) with CHF III-IV  FC by NYHA,  with ejection  fraction  of the  left ventricle  (LVEF)  about  in average  27±8%.Mean  level of natriuretic  B-type  peptide  was  1129  (Me 854, Q25 396, Q75 1419) pg/mL. Main etiology of chronic HF in participants  was dilation  cardiomyopathy:  noncoronary  cardiomyopathy  in 30 patients  (27,7%), ischemic cardiomyopathy  (ischemic  heart  disease, postinfarction  cardiosclerosis) in 72 patients (66,7%) and acquired valve defects  in 6 patients (5,6%). For assessment of efficacy of the drug in various grade  of HF severity, patients  were selected to subgroups according  to the level of LVEF decrease (less 20%, 21-30%, 31-40%, more 40%), and pulmonary artery pressure (PAWP) (less 40 mmHg, 40-70 mmHg, more 70 mmHg).Results. Infusion of the drug led to statistically significant increase of LVEF comparing to the baseline (57%), decrease of PAWP (64%) and BNP concentration in 77% cases. Conclusion. The LS is an effective medication which can be applied with the aims to prepare HF patients to cardiosurgical operations. Most sensitive parameters of LS efficacy are PAWP, LVEF and BNP concentration. The highest efficacy of the drug was observed  in subgroup  with EF ≤40%, PAWP ≥40 mmHg and BNP ≥600 pg/mL. LS, applied in HF patients  before  cardiosurgery, can  be  used  for assessment of reserves  of myocardial capacity.https://russjcardiol.elpub.ru/jour/article/view/1598heart failurelevosimendanmyocardial reserveleft ventricle ejection fractionpulmonary artery pressurenatriuretic b-type peptide
spellingShingle M. A. Babaev
A. A. Eremenko
O. V. Dymova
P. V. Polyakova
S. V. Fedulova
Yu. V. Frolova
LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILURE
Российский кардиологический журнал
heart failure
levosimendan
myocardial reserve
left ventricle ejection fraction
pulmonary artery pressure
natriuretic b-type peptide
title LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILURE
title_full LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILURE
title_fullStr LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILURE
title_full_unstemmed LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILURE
title_short LEVOSIMENDAN IN PREOPERATION THERAPY FOR CARDIOSURGERY IN PATIENTS WITH CHRONIC HEART FAILURE
title_sort levosimendan in preoperation therapy for cardiosurgery in patients with chronic heart failure
topic heart failure
levosimendan
myocardial reserve
left ventricle ejection fraction
pulmonary artery pressure
natriuretic b-type peptide
url https://russjcardiol.elpub.ru/jour/article/view/1598
work_keys_str_mv AT mababaev levosimendaninpreoperationtherapyforcardiosurgeryinpatientswithchronicheartfailure
AT aaeremenko levosimendaninpreoperationtherapyforcardiosurgeryinpatientswithchronicheartfailure
AT ovdymova levosimendaninpreoperationtherapyforcardiosurgeryinpatientswithchronicheartfailure
AT pvpolyakova levosimendaninpreoperationtherapyforcardiosurgeryinpatientswithchronicheartfailure
AT svfedulova levosimendaninpreoperationtherapyforcardiosurgeryinpatientswithchronicheartfailure
AT yuvfrolova levosimendaninpreoperationtherapyforcardiosurgeryinpatientswithchronicheartfailure