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Long‐term effects of levosimendan infusion on inflammatory processes and sFas in patients with severe heart failure
Author(s) -
Trikas Athanasios,
Antoniades Charalambos,
Latsios Giorgos,
Vasiliadou Karmen,
Karamitros Ioannis,
Tousoulis Dimitris,
Tentolouris Costantinos,
Stefanadis Christodoulos
Publication year - 2006
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.2006.03.003
Subject(s) - levosimendan , medicine , heart failure , placebo , proinflammatory cytokine , hemodynamics , dobutamine , cardiology , inflammation , anesthesia , alternative medicine , pathology
Background The calcium sensitizer levosimendan improves myocardial contractility in patients with heart failure, although its effects on inflammation and apoptosis are unknown. Aim To examine the effects of levosimendan on markers of inflammation and apoptosis, over a period of 30 d following a 24 h infusion, in patients with heart failure. Methods Thirty four patients with severe heart failure were randomised to receive a 24 h infusion of levosimendan or placebo, in a double‐blind trial. Haemodynamic evaluation and blood sampling were performed at baseline, 24 h, 30 h, 48 h, 7 d and 30 d after the end of the infusion. Results Seven patients (1 levosimendan, 6 placebo), were excluded during follow‐up. In the remaining 27 patients, levosimendan decreased serum IL‐6 and sFAS, 24 h after the infusion ( p <0.01 and p <0.05 vs baseline), an effect sustained for 7–30 d. Serum TNF‐α and sTNF‐R1 were decreased between 48 h ( p <0.01 vs baseline for both) and 7 d ( p <0.05 vs baseline for sTNF‐R1) after infusion. Serum sTNF‐R2 was decreased at 24 h ( p <0.05 vs baseline) and remained lower than baseline for at least 7 d ( p <0.05). Conclusions These findings indicate that levosimendan decreases the expression of proinflammatory cytokines, TNF‐α receptors and sFAS, immediately after infusion, an effect which persists for 7–30 d.