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Effects of Levosimendan on cardiac function, size and strain in heart failure patients

D Beitzke1, F Gremmel2, D Senn3

  • 1Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. dietrich.beitzke@meduniwien.ac.at.

The International Journal of Cardiovascular Imaging
|October 26, 2020
PubMed

Insights

Levosimendan reduced left ventricular (LV) size in heart failure patients within a week, but did not improve LV ejection fraction or strain rates. Cardiac magnetic resonance (CMR) effectively monitored these short-term cardiac effects.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Pharmacology

Background:

  • Levosimendan is used to improve cardiac function in heart failure.
  • Its precise mechanism of action requires further elucidation.
  • Multiparametric cardiac magnetic resonance (CMR) offers detailed insights into cardiac structure and function.

Purpose of the Study:

  • To investigate the short-term effects of levosimendan on cardiac function in heart failure patients.
  • To assess changes in left ventricular (LV) volumes, ejection fraction (LVEF), and strain rates using CMR.
  • To explore the relationship between LV scarring and the response to levosimendan.

Main Methods:

  • 33 heart failure patients (ischemic or non-ischemic cardiomyopathy) underwent two CMR scans before and after levosimendan infusion.
  • LV volumes (end-diastolic volume [EDV], end-systolic volume [ESV]), LVEF, and strain rates were measured.
  • Late gadolinium enhancement (LGE) was used to quantify LV scarring.

Main Results:

  • Levosimendan significantly decreased LV end-diastolic volume (p=0.001) and LV end-systolic volume (p=0.002).
  • No significant changes were observed in LVEF (p=0.41), cardiac output (p=0.61), or strain rates.
  • Subgroup analysis revealed no significant differences between ischemic and non-ischemic cardiomyopathy groups.
  • LV scarring extent did not correlate with changes in LV size or strain rates.

Conclusions:

  • Short-term levosimendan administration in heart failure patients leads to a significant reduction in LV size.
  • Levosimendan does not acutely impact LVEF or myocardial strain rates.
  • CMR is a valuable tool for monitoring the cardiac effects of levosimendan.
  • LV scarring does not predict the short-term volumetric response to levosimendan.

Keywords:
Cardiac magnetic resonanceHeart failureLevosimendanStrain imaging

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