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The Ca 2+ ‐sensitizer levosimendan improves oxidative damage, BNP and pro‐inflammatory cytokine levels in patients with advanced decompensated heart failure in comparison to dobutamine
Author(s) -
Avgeropoulou Catherine,
Andreadou Ioanna,
MarkantonisKyroudis Sophia,
Demopoulou Maritina,
Missovoulos Platon,
Androulakis Aris,
Kallikazaros Ioannis
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.02.002
Subject(s) - levosimendan , medicine , dobutamine , heart failure , inotrope , natriuretic peptide , cardiology , malondialdehyde , brain natriuretic peptide , acute decompensated heart failure , oxidative stress , hemodynamics
Aim To investigate the effect of a new inotropic drug, levosimendan compared with dobutamine on levels of brain natriuretic peptide (BNP), interleukin‐6 (IL‐6), tumor necrosis factor alpha (TNF‐α), and malondialdehyde (MDA) in patients with severe decompensated heart failure. Methods and results Twenty‐nine consecutive patients (22 males and 7 females), mean age 70.5±9.9 years, with decompensated heart failure on standard medical therapy, were randomised to receive either a 24 h infusion of levosimendan ( n =15) or dobutamine ( n =14). Blood samples were drawn at baseline, 48 h and 5 days post infusion. Levosimendan produced a significant reduction in BNP compared to baseline, at both 48 h (744.1±100 vs 1136.3±93.7 pg/ml, p =0.04) and 5 days (446±119.3 vs 1136.3±93.7 pg/ml, p =0.03), while IL‐6 values decreased after 5 days (4.8±1.3 vs 8.6±1.5 pg/ml, p =0.01). MDA levels were significantly lower 5 days after levosimendan compared to baseline (2.3±0.2 vs 3±0.3 μM, p =0.01). TNF‐α levels did not differ between the groups. The comparison of percentage alteration compared to baseline showed that BNP (–44.5±7.6% vs 4.8±18.7%, p =0.025), MDA (–21.8±5.1% vs 14.9±8.5%, p =0.001) and IL‐6 (–38.8±12.5% vs 70.2±24%, p =0.001) levels were significantly lower in the levosimendan group 5 days after treatment compared to the dobutamine group. Conclusions Treatment with levosimendan in advanced decompensated heart failure exerts a beneficial hemodynamic, anti‐inflammatory and antioxidant effect. These findings may give an insight into the favourable impact on mortality that levosimendan appears to have in published multicenter trials.