左西孟旦对缺血性心力衰竭患者右心室收缩和舒张功能的影响。
Effect of levosimendan on right ventricular systolic and diastolic functions in patients with ischaemic heart failure.
作者信息
Duygu H, Ozerkan F, Zoghi M, Nalbantgil S, Yildiz A, Akilli A, Akin M, Nazli C, Ergene O
机构信息
Department of Cardiology, Ataturk Training and Research Hospital, Izmir, Turkey.
出版信息
Int J Clin Pract. 2008 Feb;62(2):228-33. doi: 10.1111/j.1742-1241.2007.01510.x. Epub 2007 Oct 19.
OBJECTIVES
Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. In this study, the effect of levosimendan on the right ventricular systolic and diastolic functions was evaluated by tissue Doppler comparing them with dobutamine in patients with ischaemic heart failure.
METHODS
Patients having an acute decompensated heart failure with ischaemic cardiomyopathy and left ventricular ejection fraction <40% were included in the study. Before and 24-h after treatment, peak systolic (Sa), peak early (Ea), peak late (Aa) diastolic annular velocities and Ea/Aa ratio from tricuspid lateral annulus by tissue Doppler and systolic pulmonary artery pressure (SPAP) were measured.
RESULTS
Sa, Ea and the Ea/Aa ratio were significantly increased in the levosimendan group whereas SPAP was significantly reduced. In the dobutamine group, no significant differences were observed in the Sa, Ea, Aa and Ea/Aa ratio in spite of a significant reduction in SPAP. Decrease in SPAP was greater in the levosimendan group (p=0.002).
CONCLUSION
Levosimendan improves right ventricular systolic and diastolic functions.
目的
左西孟旦是一种用于急性左心衰竭的新型正性肌力钙增敏剂。在本研究中，通过组织多普勒评估左西孟旦对缺血性心力衰竭患者右心室收缩和舒张功能的影响，并与多巴酚丁胺进行比较。
方法
纳入患有急性失代偿性心力衰竭且伴有缺血性心肌病、左心室射血分数<40%的患者。在治疗前和治疗后24小时，通过组织多普勒测量三尖瓣侧环的收缩期峰值（Sa）、舒张早期峰值（Ea）、舒张晚期峰值（Aa）以及舒张期环速度和Ea/Aa比值，并测量收缩期肺动脉压（SPAP）。
结果
左西孟旦组的Sa、Ea和Ea/Aa比值显著增加，而SPAP显著降低。在多巴酚丁胺组中，尽管SPAP显著降低，但Sa、Ea、Aa和Ea/Aa比值未观察到显著差异。左西孟旦组SPAP的降低幅度更大（p=0.002）。
结论
左西孟旦可改善右心室收缩和舒张功能。
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