Havva Sezer, Güzin Zeren Öztürk, Mehmet Hurşitoğlu, Osman Kara, İlker Jordan, Tufan Tükek
Objective: The calcium sensitizer levosimendan is one of the best documented pharmacological agents used in the management of advanced heart failure syndromes. It improves cardiac performance, but Its effect on arrhythmia development is not investigated well. The aim of this study was to determine the inotropic effect of levosimendan and its duration and to investigate whether it caused arrhythmia.
Methods: Twenty-four patients (in sinus rhythm) with stage III-IV heart failure were enrolled in the study. Brain natriuretic peptide (BNP), echocardiography, 24-hour rhythm Holter, heart rate variability analysis (HRV), signal-averaged ECG were performed. These tests were repeated on days 1, 15 (BNP and echocardiography only), and 28 following levosimendan infusion therapy.
Results: Brain natriuretic peptide level was reduced on day 1. and increased on days 15. and 28. left ventricular ejection fraction was increased significantly on the first day and reduced on days 15 and 28, however the difference remained significant. Reduction of miyocardial performance index (Tei İndex) was significantly on the first day. Late potential positivity was found in 7 patients at the baseline. After treatment it was found in 5 patients on Day 1 and in 8 patients on day 28. Regarding atrial fibrillation, no difference was found compared to the baseline. Standard deviation of all normal RR intervals (SDNN) and Standard deviation of average NN (RR) intervals (SDANN) increased significantly on day 28.
Conclusion: Levosimendan increases left ventricular performance and does not have an effect on arrhythmia development and provides partial improvement in HRV analysis.
Key words: advanced heart failure
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