Effects of Levosimendan on haemodynamics in heart failure patients with low cardiac output

Abstract

Objective To investigate effects of Levosimendan on hemodynamics in heart failure patients with low cardiac output. Methods A total of 27 heart failure patients with low cardiac output were recruited in the surgical intensive care unit(SICU)of Beijing Hospital from July 2009 to May 2016.All patients were treated with continuous intravenous infusion of Levosimendan 12.5 mg within 24 h at a rate of 0.1~0.2 μg· kg-1·min-1.Hemodynamic variables were monitored by pulse-indicated continuous cardiac output(PICCO)at baseline, 24 h, 4 d and 7 d after infusion. Results There were no significant differences in systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR)and global end diastolic volume index(GEDI)as comparing baseline with 24 h, 4 d and 7 d after infusion of levosimendan.The significant differences were found in central venous pressure(CVP), systemic vessel resistance index(SVRI), extravascular lung water index(EVLWI)among baseline versus 24 h, 4 d and 7 d after infusion of levosimendan[(8.34± 2.87)mmHg vs.(6.35± 2.31), (6.81± 2.03), (5.92± 2.23)mmHg for CVP, (2 682.0± 388.9)dyn·s-1·cm-5·m-2vs.(2 170.0± 410.9), (2 062.0± 340.6), (1 960.0± 380.2)dyn·s-1·cm-5·m-2 for SVRI, (8.90± 2.45)ml/kg vs.(6.60± 2.66), (5.92± 2.88), (5.46± 2.52)ml/kg for EVLWI, P=0.001, 0.003 or<0.01, respectively]. As compared with hemodynamic variables at baseline, brain natriuretic peptide levels were decreased, and cardiac index, cardiac function index and stroke volume index were increased at 24 h, 4 d and 7 d after infusion of Levosimendan(P<0.01, 0.05 or 0.01, respectively). Conclusions A single-dose intravenous infusion of Levosimendan can increase cardiac output and decrease systemic vascular resistance in heart failure patients with low cardiac output, which maintain quite a long time. Key words: Levosimendan; Cardiac output, low; Heart failure; Hemodynamics