Department of Cardiology, Helsinki University Central Hospital, Helsinki, Finland.
Scand Cardiovasc J. 2011 Apr;45(2):91-7. doi: 10.3109/14017431.2011.557779. Epub 2011 Feb 25.
Oral levosimendan improves ventricular function in short-term clinical trials. The effects of long-term treatment with oral levosimendan were investigated on echocardiographic parameters of left ventricular function in patients with chronic heart failure.
Twenty-nine patients with NYHA III-IV congestive chronic HF were prospectively enrolled in a randomised, double-blind, placebo controlled study. Oral levosimendan was administered on top of existing medication over a treatment period of at least 180 days. Echocardiographic measurements estimating pulmonary capillary wedge pressure (PCWP) and tissue Doppler mitral basal myocardial velocities (Sm, Em) were performed at baseline and 90 and 180 days after randomisation.
Estimated PCWP at baseline was elevated in both groups and decreased by 13% in the levosimendan group compared to an increase of 9% in the placebo group (p = 0.035). Sm was decreased in both groups at baseline and improved by 0.9 cm/s in the levosimendan group and decreased by 0.1 cm/s in the placebo group (p = 0.035). Levosimendan did not significantly alter heart rate or systolic blood pressure.
Oral levosimendan improved hemodynamic function in chronic heart failure patients and the effect was sustained over the 180-day follow-up period.
口服左西孟旦在短期临床试验中改善了心室功能。本研究旨在探讨长期口服左西孟旦对慢性心力衰竭患者左心室功能的超声心动图参数的影响。
29 例 NYHA III-IV 级充血性慢性 HF 患者前瞻性纳入一项随机、双盲、安慰剂对照研究。在至少 180 天的治疗期间，在现有药物治疗的基础上加用口服左西孟旦。在随机分组后 90 和 180 天，进行估计肺毛细血管楔压（PCWP）和组织多普勒二尖瓣基底部心肌速度（Sm、Em）的超声心动图测量。
两组患者的基线 PCWP 均升高，左西孟旦组较安慰剂组降低 13%（p = 0.035）。两组患者的 Sm 在基线时均降低，左西孟旦组增加 0.9cm/s，安慰剂组降低 0.1cm/s（p = 0.035）。左西孟旦对心率或收缩压无显著影响。
口服左西孟旦改善了慢性心力衰竭患者的血液动力学功能，这种作用在 180 天的随访期间持续存在。
