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Effect of Levosimendan on Diastolic Function in Patients Undergoing Coronary Artery Bypass Grafting: A Comparative

Vishwas Malik1, Arun Subramanian, Milind Hote

  • 1Departments of *Cardiac Anesthesiology; and †Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.

Journal of Cardiovascular Pharmacology
|April 29, 2015
PubMed

Insights

Levosimendan significantly improved diastolic function in patients undergoing coronary artery bypass grafting compared to nitroglycerin. This study highlights levosimendan

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Pharmacology

Background:

  • Diastolic dysfunction is a common complication in patients undergoing coronary artery bypass grafting (CABG).
  • Optimizing diastolic function perioperatively is crucial for improving patient outcomes.
  • Current therapeutic options for diastolic dysfunction during CABG have limitations.

Purpose of the Study:

  • To compare the efficacy of levosimendan versus nitroglycerin in improving diastolic function.
  • To evaluate the impact of these agents on diastolic parameters during on-pump CABG.
  • To assess changes in N-terminal fragment of pro-B-natriuretic peptide (NT-proBNP) levels.

Main Methods:

  • Thirty patients with isolated diastolic dysfunction undergoing CABG were randomized into two groups.
  • Levosimendan or nitroglycerin infusion was administered pre-sternotomy and continued postoperatively.
  • Diastolic function was assessed using echocardiography at three time points; NT-proBNP levels were also measured.

Main Results:

  • Levosimendan significantly improved isovolumic relaxation time and deceleration time compared to baseline and nitroglycerin.
  • Tissue Doppler imaging showed enhanced diastolic function in the levosimendan group.
  • NT-proBNP levels indicated a similar pattern between groups, with improvements noted in the levosimendan group for pseudonormal patterns.

Conclusions:

  • Levosimendan demonstrates superior efficacy in enhancing diastolic function compared to nitroglycerin.
  • The benefits of levosimendan on diastolic function are observed irrespective of coronary revascularization status.
  • Levosimendan represents a promising therapeutic option for managing diastolic dysfunction in cardiac surgery patients.
Abstract

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