Evidence map›Paper›PMID 34584384›Full record

ArticleActa Cardiologica Sinica2021

Effects of Levosimendan on Systemic Perfusion in Patients with Low Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Score: Experience from a Single Center in Taiwan.

Ying-Hsiang Wang, Jia-Lin Chen, Chien-Sung Tsai, Yi-Ting Tsai, Chih-Yuan Lin, Hong-Yan Ke, Po-Shun Hsu

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Article in Acta Cardiologica Sinica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ying-Hsiang WangDivision of Cardiovascular Surgery, Department of Surgery.
Jia-Lin ChenDepartment of Anesthesia, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Chien-Sung TsaiDivision of Cardiovascular Surgery, Department of Surgery.
Yi-Ting TsaiDivision of Cardiovascular Surgery, Department of Surgery.
Chih-Yuan LinDivision of Cardiovascular Surgery, Department of Surgery.
Hong-Yan KeDivision of Cardiovascular Surgery, Department of Surgery.
Po-Shun HsuDivision of Cardiovascular Surgery, Department of Surgery.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with cardiogenic shock have a high risk of mortality. Intravenous levosimendan can provide pharmacologic inotrope support.

objectivesWe aimed to investigate the effect of levosimendan in patients with extremely severe cardiogenic shock and low Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) score with or without mechanical circulatory support.

methodsFrom January 2017 to May 2019, 24 patients with INTERMACS 1-4 were enrolled in this retrospective study. All patients had systemic malperfusion and were treated with levosimendan. Biochemistry data related to systemic perfusion were recorded and compared before and at 24 and 72 hours after levosimendan administration. Echocardiography and Kansas City Cardiomyopathy Questionnaire (KCCQ) were completed 2 months later to assess left ventricular ejection fraction (LVEF) and quality of life (QoL), respectively.

resultsArterial pressure and heart rate did not significantly differ before and after levosimendan administration. Atrial fibrillation and ventricular premature complex increased without significance. The dose of inotropes could be significantly tapered down. There were no significant differences in blood urea nitrogen, creatinine, and lactate levels. Urine output significantly increased (p = 0.018), and liver-related enzymes improved but without significance. B-type natriuretic peptide significantly decreased (p = 0.007) at 24 hours after levosimendan administration. Echocardiography showed significantly improved LVEF 2 months later (22.43 ± 8.13% to 35.87 ± 13.4%, p = 0.001). KCCQ showed significantly improved physical activity and greater relief of symptoms (p = 0.003). The survival-to-discharge rate was 75%.

conclusionsWe observed a decrease in B-type natriuretic peptide, better urine output, and alleviated hepatic injury in the levosimendan group. Most patients who survived without transplantation had significantly improved LVEF and better QoL after levosimendan administration.

Indexed as

Cardiogenic shockEnd-stage heart failureLevosimendanSystemic perfusion

Identifiers

PMID34584384
PMCPMC8414063

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