Guo Yi, Zhou Chaofei, Yang Xia
Department of Cardiology, Hainan Branch of Chinese People's Liberation Army General Hospital, Sanya 572013, China.
Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Ann Transl Med. 2018 Nov;6(22):438. doi: 10.21037/atm.2018.10.15.
Takotsubo syndrome has a low global incidence, but it is observed more and more in clinical practice. Only case reports and series have been published, while prospective studies are still necessary. This study aimed to explore the efficacy and safety of levosimendan in elderly with Takotsubo syndrome.
This study followed a prospective, randomized and double-blinded design. All 200 consecutive patients (>65 years) with Takotsubo syndrome were randomly assigned into a levosimendan group (n=100) and a control group (n=100). The control group underwent regular treatment, and the levosimendan group was additionally administrated with levosimendan.
Age of all patients was 71 [66-85] years, and there were 138 females (69%). Baseline characteristics between the two groups had no significant difference before treatment (P>0.05 for all). In the levosimendan group on the 30 and 180 days after treatment, left ventricular ejection fraction was significantly higher, and New York Heart Association class and N-terminal pro-brain natriuretic peptide levels were significantly lower, than those in the control group (P<0.05 for all). Systolic blood pressure, diastolic blood pressure, heart rate and serum creatinine levels had no significant difference between the two groups (P>0.05 for all).
Levosimendan showed reliable efficacy and safety in Chinese elderly patients with Takotsubo syndrome, supporting the idea that levosimendan has the potential to be an essential drug applied for patients with Takotsubo syndrome.
应激性心肌病在全球发病率较低，但在临床实践中其发现越来越多。目前仅有病例报告和病例系列发表，前瞻性研究仍有必要。本研究旨在探讨左西孟旦对老年应激性心肌病患者的疗效和安全性。
本研究采用前瞻性、随机、双盲设计。连续纳入200例年龄>65岁的应激性心肌病患者，随机分为左西孟旦组（n = 100）和对照组（n = 100）。对照组接受常规治疗，左西孟旦组在常规治疗基础上额外给予左西孟旦。
所有患者年龄为71[66 - 85]岁，女性138例（69%）。两组治疗前基线特征无显著差异（所有P>0.05）。治疗后30天和180天，左西孟旦组左心室射血分数显著高于对照组，纽约心脏协会心功能分级及N末端脑钠肽前体水平显著低于对照组（所有P<0.05）。两组收缩压、舒张压、心率及血清肌酐水平无显著差异（所有P>0.05）。
左西孟旦对中国老年应激性心肌病患者显示出可靠的疗效和安全性，支持左西孟旦有可能成为应激性心肌病患者的基本用药这一观点。
