PMID- 18973957
OWN - NLM
STAT- MEDLINE
DCOM- 20100505
LR  - 20181201
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 139
IP  - 1
DP  - 2010 Feb 18
TI  - Plasma B-type natriuretic peptide reduction predicts long-term response to 
      levosimendan therapy in acutely decompensated chronic heart failure.
PG  - 75-9
LID - 10.1016/j.ijcard.2008.10.003 [doi]
AB  - OBJECTIVE: We sought to identify predictors of long-term response to levosimendan 
      therapy among patients' baseline features and treatment-induced changes in 
      acutely decompensated chronic heart failure (ADHF). METHODS: Ninety-eight 
      consecutive patients [aged 64+/-10 years, New York Heart Association (NYHA) 
      classes III-IV, left ventricular ejection fraction <35%], 69 treated with 
      levosimendan and 29 with standard therapy, underwent a clinical, 
      echocardiographic and biochemical assessment before and after treatment. All 
      patients were subsequently followed for 6 months for death or rehospitalization 
      for ADHF. RESULTS: Compared to standard therapy, levosimendan induced a 
      significant improvement in NYHA class (F=37.529, p<0.001), B-type natriuretic 
      peptide (BNP, F=22.917, p<0.001), left ventricular ejection fraction (F=23.561, 
      p<0.001), transmitral E deceleration time (DT, F=6.499, p=0.013) and E/e ratio 
      (F=10.812, p=0.003). During follow-up, 88 of 98 patients (90%) experienced an 
      event. Event-free survival (days alive and out of hospital) at 6 months was 
      similar in two groups (median, 48 days, log-rank test p=0.6760). In the 
      levosimendan group, treatment-induced percent BNP change was the best predictor 
      of events (OR=0.970, 95% CI=0.954-0.986, p<0.001). A cut-off for BNP change of 
      58% predicted events with 87% sensitivity and 83% specificity. Event-free 
      survival was longer in patients with a BNP reduction > or =58% (median, 135 
      versus 43 days, p=0.0001). CONCLUSION: Treatment-induced BNP reduction is an 
      independent predictor of 6-month outcome following levosimendan therapy in ADHF.
CI  - Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
FAU - Farmakis, Dimitrios
AU  - Farmakis D
AD  - Second Department of Cardiology and Heart Failure Unit, Attiko University 
      Hospital, Athens, Greece. dimitrios_farmakis@yahoo.com
FAU - Parissis, John T
AU  - Parissis JT
FAU - Bistola, Vassiliki
AU  - Bistola V
FAU - Paraskevaidis, Ioannis A
AU  - Paraskevaidis IA
FAU - Iliodromitis, Efstathios K
AU  - Iliodromitis EK
FAU - Filippatos, Gerasimos
AU  - Filippatos G
FAU - Kremastinos, Dimitrios T
AU  - Kremastinos DT
LA  - eng
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20081030
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Biomarkers)
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Hydrazones)
RN  - 0 (Pyridazines)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 349552KRHK (Simendan)
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Biomarkers/blood
MH  - Cardiotonic Agents/*therapeutic use
MH  - Chronic Disease
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*blood/diagnostic imaging/*drug therapy
MH  - Heart Function Tests
MH  - Humans
MH  - Hydrazones/*therapeutic use
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Patient Readmission/statistics & numerical data
MH  - Predictive Value of Tests
MH  - Pyridazines/*therapeutic use
MH  - Sensitivity and Specificity
MH  - Simendan
MH  - Ultrasonography
EDAT- 2008/11/01 09:00
MHDA- 2010/05/06 06:00
CRDT- 2008/11/01 09:00
PHST- 2008/06/28 00:00 [received]
PHST- 2008/10/01 00:00 [accepted]
PHST- 2008/11/01 09:00 [pubmed]
PHST- 2010/05/06 06:00 [medline]
PHST- 2008/11/01 09:00 [entrez]
AID - S0167-5273(08)01053-X [pii]
AID - 10.1016/j.ijcard.2008.10.003 [doi]
PST - ppublish
SO  - Int J Cardiol. 2010 Feb 18;139(1):75-9. doi: 10.1016/j.ijcard.2008.10.003. Epub 
      2008 Oct 30.