Author + information
- Yüksel Çavuşoğlu,
- Aydın Nadir,
- Kadir Uğur Mert,
- Erkan Gencer,
- Bektas Morrad,
- Fezan Mutlu and
- Taner Ulus
Levosimendan has been shown to have a better hemodynamic profile over dobutamine in increasing cardiac output and reducing pulmonary wedge pressure in patients with acute decompensated heart failure (HF). Data comparing the effect of levosimendan with dobutamine on systolic time intervals is lacking. Therefore, the aim of this study was to evaluate the effects of levosimendan and dobutamine on systolic time intervals.
Fifty patients with NYHA class III-IV decompensated HF requiring inotropic support, LVEF <35% and in sinus rhythm were randomized (in a 1:1 design) to levosimendan (n=25) or dobutamine (n=25). Both inotropic agents were administered as a continuous 24-h infusion (levosimendan at a dose of 0.2 μgr/kg/min with a preceding bolus dose of 12 μgr/kg and dobutamine at a dose of 10 μgr/kg/min without a bolus dose). All patients underwent echocardiographic evaluation before and at the end of inotropic infusion. LVEF, heart rate-corrected electromechanical systole (QS2i), pre-ejection period (PEP) and left ventricular ejection time (LVET) were measured.
There was no significant difference in baseline clinical characteristics and laboratory parameters between levosimendan and dobutamine groups. As compared with their baseline values, LVEF and LVET significantly increased at the end of both levosimendan and dobutamine infusions with a similar extent in both groups (table). Levosimendan significantly shortened QS2i and PEP. Dobutamine shortened PEP, but showed no effect on QS2i.
This study suggests that both levosimendan and dobutamine are almost equally effective in increasing LVET and in shortening PEP. However, levosimendan appears to have additional advantage over dobutamine in shortening QS2i, indicating a fairly strong positive inotropic effect.
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