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Comparative effects of levosimendan and dobutamine on right ventricular function in patients with biventricular heart failure

机译：左西孟旦和多巴酚丁胺对双心性心力衰竭患者右心室功能的比较作用

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摘要

Severe heart failure represents a major source of morbidity and mortality. Poor right ventricular function is an independent prognostic marker for mortality in patients with chronic heart failure. In this study, levosimendan (L) and dobutamine (D) in patients with severe chronic biventricular failure were compared. Forty consecutive patients, who were judged for inotropic therapy by their primary physicians, with acutely decompensated systolic heart failure and having moderate-to-severe right ventricular dysfunction with right ventricular fractional area change of ≤24%m were randomized to L and D in a 2:1 fashion. Echocardiographic parameters including tricuspid annular motion and clinical issues were considered. Mean age and sex distribution were not different between the two groups. After the infusion, ejection fraction improved and systolic pulmonary artery pressure decreased significantly in both arms. Longitudinal systolic function of tricuspid annulus improved significantly better in patients with L compared to patients with D (15% ± 12% vs. 2% ± 6% improvement, P < 0.001). Furthermore, L improved both 24-h urine output and creatinine, whereas D showed only a small, but significant improvement in urine output without any improvement in the creatinine levels. Levosimendan seems to offer more beneficial effects compared to dobutamine in a specific group of patients with biventricular failure.
机译：严重的心力衰竭是发病率和死亡率的主要来源。右心室功能不佳是慢性心力衰竭患者死亡率的独立预后指标。在这项研究中，将左西孟旦（L）和多巴酚丁胺（D）用于严重的慢性双心衰患者。连续40例经主治医师判断为正性肌力疗法，急性代偿性收缩期心力衰竭，右室功能中度至重度下降至≤24％m的中度至重度患者被随机分为L和D组。 2：1时尚。超声心动图参数包括三尖瓣环运动和临床问题。两组之间的平均年龄和性别分布没有差异。输注后，两臂的射血分数均得到改善，并且收缩期肺动脉压力显着降低。与D患者相比，L患者三尖瓣环的纵向收缩功能明显改善（D改善15％±12％，而2％±6％改善，P <0.001）。此外，L改善了24小时尿量和肌酐，而D仅显示了少量但显着的尿量改善，而肌酐水平没有任何改善。与多巴酚丁胺相比，左西孟旦似乎在一组特定的双室衰竭患者中提供了更多的有益作用。

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