Effect of levosimendan on postoperative hemodynamics in patients with severe valvular heart disease

Abstract

Objective To observe the effect of levosimendan on postoperative hemodynamics in patients with severe valvular heart disease. Methods Sixty-six patients with severe valvular disease in Xinjiang Cardiovascular and Cerebrovascular Disease Hospital from April 2016 to December 2017 were enrolled. They were randomly divided into levosimendan group (n=33) to receive levosimendan and control group (n=33) to receive routine treatment with dopamine or dobutamine. The hemodynamic parameters were measured immediately and at 12, 24, 48 and 72 h after the surgery. Cardiac troponin I, creatine kinase MB and N-terminal pro brain natriuretic peptide were measured before and at 1, 3, 7 d after the operation. All adverse events were recorded. Results Compared with the parameters of the control group, the systemic vascular resistance index, central venous pressure, extra vascular lung water index and the serum of lactic acid of the levosimendan group significantly decreased, while the every cardiac index, left ventricular stroke work index and heart index significantly increased (all P<0.05), at 24, 48 and 72 h after the surgery. The level of cardiac troponin I in 3 and 7 d (t=16.27, P=0.01; t=18.15, P=0.00) and N-terminal pro brain natriuretic peptide in 1, 3 and 7 d (t=16.27, P=0.01; t=10.18, P=0.02; t=22.21, P=0.00) significantly decreased after the surgery. The ICU retention time, ventilation time, hospitalization time and acute kidney injury were significantly reduced in levosimendan group (t=8.62, P=0.03; t=10.28, P=0.02; t=14.12, P=0.00; t=3.99, P=0.04). Conclusions Levosimendan can significantly improve the hemodynamics and cardiac function of the patients with severe valvular heart disease, reduce the incidence of postoperative adverse events. Key words: Levosimendan; Heart valve diseases; Hemodynamics; Postoperative complications