PMID- 27390145
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220410
IS  - 1940-4034 (Electronic)
IS  - 1074-2484 (Linking)
VI  - 22
IP  - 2
DP  - 2017 Mar
TI  - Comparison of the Effects of Levosimendan Dobutamine and Vasodilator Therapy on 
      Ongoing Myocardial Injury in Acute Decompensated Heart Failure.
PG  - 153-158
LID - 10.1177/1074248416657612 [doi]
AB  - BACKGROUND: Cardiac troponins (cTn) are reliable and the most sensitive biomarker 
      in the setting of acute decompensated heart failure (ADHF). Acute decompensated 
      heart failure is usually associated with worsening chronic heart failure, and it 
      may be caused by ongoing minor myocardial cell damage that may occur without any 
      reported precipitating factors. METHODS: We compared the short-term effect of 
      levosimendan (LEV), dobutamine (DOB), and vasodilator treatment (nitroglycerin 
      [NTG]) on myocardial injury with hemodynamic, neurohumoral, and inflammatory 
      indicators. One hundred twenty-two patients with a mean age of 66 +/- 9 years were 
      treated with LEV (n = 40), DOB (n = 42), and NTG (n = 40) and examined 
      retrospectively. Blood samples (cTnI, N-terminal probrain natriuretic peptide 
      [NT-proBNP], highly sensitive C-reactive protein [HsCRP], and others), left 
      ventricular ejection fraction (LVEF), systolic pulmonary artery pressure (sPAP), 
      and 6-minute walk distance (6MWD) were compared before and after treatment. 
      RESULTS: At admission, detectable levels of cTnI were observed in 53% of patients 
      (>/=0.05 ng/mL). Serial changes in the mean cTnI levels were not significantly 
      different between the groups (LEV 0.04 +/- 0.01 to 0.03 +/- 0.01 ng/mL; DOB 0.145 +/- 
      0.08 to 0.08 +/- 0.03 ng/mL; NTG 0.1 +/- 0.03 to 0.09 +/- 0.02 ng/mL; overall P = 
      .859). Favourable effects on the NT-proBNP, sPAP values, LVEF, 6MWD, and HsCRP 
      were observed overall, especially in the LEV groups. CONCLUSION: Beneficial 
      effects of short-term use of LEV, DOB, and NTG on ongoing myocardial injury were 
      demonstrated. These findings can be attributed to the anti-ischemic properties as 
      well as the hemodynamic, neurohumoral, and functional benefits from the positive 
      inotropes, especially LEV, in patients with ADHF.
FAU - Gencer, Erkan
AU  - Gencer E
AD  - 1 Department of Cardiology, Cardiology Clinic, Kilis State Hospital, Kilis, 
      Turkey.
FAU - Dogan, Volkan
AU  - Dogan V
AD  - 2 Department of Cardiology, Mugla Sitki Kocman University, Mugla, Turkey.
FAU - Ozturk, Mujgan Tek
AU  - Ozturk MT
AD  - 3 Department of Cardiology, Cardiology Clinic, Kecioren Education and Research 
      Hospital, Ankara, Turkey.
FAU - Nadir, Aydin
AU  - Nadir A
AD  - 4 Department of Cardiology, Cardiology Clinic, Bozuyuk State Hospital, Bilecik, 
      Turkey.
FAU - Musmul, Ahmet
AU  - Musmul A
AD  - 5 Department of Biostatistics, Faculty of Medicine, Eskisehir Osmangazi 
      University, Eskisehir, Turkey.
FAU - Cavusoglu, Yuksel
AU  - Cavusoglu Y
AD  - 6 Department of Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, 
      Eskisehir, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20160709
PL  - United States
TA  - J Cardiovasc Pharmacol Ther
JT  - Journal of cardiovascular pharmacology and therapeutics
JID - 9602617
OTO - NOTNLM
OT  - dobutamine
OT  - heart failure
OT  - levosimendan
OT  - troponin
EDAT- 2016/07/09 06:00
MHDA- 2016/07/09 06:01
CRDT- 2016/07/09 06:00
PHST- 2016/07/09 06:00 [pubmed]
PHST- 2016/07/09 06:01 [medline]
PHST- 2016/07/09 06:00 [entrez]
AID - 1074248416657612 [pii]
AID - 10.1177/1074248416657612 [doi]
PST - ppublish
SO  - J Cardiovasc Pharmacol Ther. 2017 Mar;22(2):153-158. doi: 
      10.1177/1074248416657612. Epub 2016 Jul 9.