Effect of levosimendan and predictors of recovery in patients with peripartum cardiomyopathy, a randomized clinical trial
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Murat Biteker . NiluپN fer EksپCi Duran . Hasan Kaya . Sabahattin GuپNnduپNz . Halil I.brahim Tanbog.a . Tayyar GoپNkdeniz . GoپNkhan Kahveci . Taylan
- چاپ و سال / کشور: 2011
Description
Background Levosimendan is a promising new inodilator agent but its effectiveness in peripartum cardiomyopathy (PPCM) has not been tested in a clinical trial. The authors sought to evaluate the effect of levosimendan therapy and to determine the predictors of clinical outcome in patients with PPCM. Methods and results The authors prospectively randomized 24 consecutive women with PPCM. Twelve patients (control group) were randomized to conventional heart failure therapy and 12 patients (levosimendan group) were randomized to levosimendan in addition to the conventional therapy. Mean follow-up period was 20.9 ± 9 months (ranged 12–38 months). The two groups did not differ in baseline demographic and echocardiographic characteristics. Eleven patients (45.8%) recovered completely (6 in control group and 5 in levosimendan group, p[0.05), 6 died (25%) (3 in control group and 3 in levosimendan group), and 7 (29.1%) were left with persistent left ventricular dysfunction (PLVD) (3 in control group and 4 in levosimendan group, p[0.05). There were significant differences in baseline characteristics between deceased patients and survivors including left ventricular end-diastolic diameter (7.1 ± 0.6 vs. 6.4 ± 0.5 cm, p = 0.031), left ventricular end-systolic diameter (LVESD) (6.4 ± 0.8 vs. 5.5 ± 0.6 cm, p = 0.027), left ventricular ejection fraction (LVEF) (19.7 vs. 27.4%, p = 0.025), and left atrial diameter (4.9 ± 0.3 vs. 4.3 ± 0.4 cm, p = 0.011). Conclusions Addition of levosimendan to conventional therapy did not improve outcome in patients with PPCM. In patients with PLVD or patients who died, LVEF, LVESD and left atrial diameter were worse than those with complete resolution.
Clin Res Cardiol (2011) 100:571–577 DOI 10.1007/s00392-010-0279-7 Received: 29 October 2010 / Accepted: 23 December 2010 / Published online: 1 January 2011
