Nanas John N, Papazoglou Panagiotis P, Terrovitis John V, Kanakakis John, Dalianis Argirios, Tsolakis Elias, Tsagalou Eleftheria P, Agrios Nikolaos, Christodoulou Kostantinos, Anastasiou-Nana Maria I
University of Athens School of Medicine, Department of Clinical Therapeutics, Alexandra Hospital, Athens, Greece.
Am J Cardiol. 2004 Nov 15;94(10):1329-32. doi: 10.1016/j.amjcard.2004.07.128.
A 24-hour infusion of levosimendan was added to dobutamine in 18 patients (aged 63 +/- 9 years) hospitalized for management of decompensated New York Heart Association functional class IV heart failure refractory to a continuous 24-hour infusion of dobutamine (10 microg/kg/min) and furosemide (10 mg/hour); the primary study end point was a >or=40% increase in cardiac index and a >or=25% decrease in pulmonary capillary wedge pressure compared with pretreatment measurements. The primary end point was reached in one of the patients treated with dobutamine alone versus 7 patients (39%) treated with levosimendan and dobutamine combined (p = 0.008), whereas at 24 hours, the combined treatment was associated with a 0.76 +/- 0.78 L/min/m(2) (p = 0.001) mean increase in cardiac index and a 6.4 +/- 7.3 mm Hg (p = 0.002) mean decrease in pulmonary capillary wedge pressure compared with measurements obtained after 24 hours of dobutamine infusion alone. Symptoms were alleviated in all patients, and all but 3 were discharged from the hospital.
18例（年龄63±9岁）因纽约心脏协会心功能IV级失代偿性心力衰竭住院治疗的患者，在持续24小时输注多巴酚丁胺（10微克/千克/分钟）和呋塞米（10毫克/小时）无效后，加用了24小时的左西孟旦输注；主要研究终点是与治疗前测量值相比，心脏指数增加≥40%且肺毛细血管楔压降低≥25%。单独使用多巴酚丁胺治疗的患者中有1例达到主要终点，而联合使用左西孟旦和多巴酚丁胺治疗的患者中有7例（39%）达到主要终点（p = 0.008）；与仅输注24小时多巴酚丁胺后测得的值相比，联合治疗在24小时时使心脏指数平均增加0.76±0.78升/分钟/平方米（p = 0.001），肺毛细血管楔压平均降低6.4±7.3毫米汞柱（p = 0.002）。所有患者症状均得到缓解，除3例患者外均已出院。
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