Levosimendan in ventricular dysfunction in the postoperative period of cardiac surgery. Hospital Santa Clara de Bogotá D.C. October 2011 to September 2012
Levosimendan en disfunción ventricular en el posoperatorio de cirugía cardíaca. Hospital Santa Clara de Bogotá D.C. Octubre 2011 a Septiembre 2012
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Badillo, E., Hennessey, J. M., & Santis, E. A. (2015). Levosimendan in ventricular dysfunction in the postoperative period of cardiac surgery. Hospital Santa Clara de Bogotá D.C. October 2011 to September 2012. Journal of Medicine and Surgery Repertoire, 24(4), 275–283. https://doi.org/10.31260/RepertMedCir.v24.n4.2015.601
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Abstract
Ventricular dysfunction after extracorporeal circulation causes low cardiac output syndrome in the postoperative period (10% prevalence). Levosimendan is a medication to improve refractory ventricular dysfunction. Objective: to describe the evolution of ventricular function in adults after cardiac surgery managed with levosimendan due to refractory ventricular dysfunction at the Hospital of Santa Clara in Bogotá DC, between October 2011 and September 2012. Methods: clinical characteristics and evolution are reported echocardiography of the ejection fraction (LVEF) with control at 24 hours and postoperatively. Results: 13 patients were evaluated, with a mean age of 59 years (SD, 10), range of 39 to 78 years, nine were men, two had diabetes mellitus. The median fraction of pre-surgical left ventricular ejection was 50% (RIQ 30% -60%). In response to the administration of levosimendan the median LVEF at 24 hours was 20% (RIQ 20% - 25%) and 35% per week (RIQ 35% - 40%). Two patients died. Conclusions: the use of levosimendan in patients with refractory left ventricular dysfunction contributes to the improvement of the ejection fraction.
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References
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7. Malliotakis P, Xenikakis T, Linardakis M, Hassoulas J. Haemodynamic effects of levosimendan for low cardiac output after cardiac surgery: a case series. Hellenic J Cardiol. 2007;48(2):80-8. Epub 2007/05/11.
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10. Tamargo J, Lopez-Sendon J. [Rationale and clinical evidence for the effects of new pharmacological treatments for heart failure]. Rev Esp Cardiol. 2004;57(5):447-64. Epub 2004/05/21. Bases y evidencias clinicas de los efectos de los nuevos tratamientos farmacologicos en la insuficiencia cardíaca.
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12. Benlolo S, Lefoll C, Katchatouryan V, Payen D, Mebazaa A. Successful use of levosimendan in a patient with peripartum cardiomyopathy. Anesth Analg.2004;98(3):822-4, table of contents. Epub 2004/02/26.
13. Cheung EH, Arcidi JM, Jr., Dorsey LM, Vinten-Johansen J, Hatcher CR, Jr., Guyton RA. Reperfusion of infarcting myocardium: benefit of surgical reperfusion in a chronic model. Ann Thorac Surg. 1989;48(3):331-8. Epub 1989/09/01.
14. Vinten-Johansen J, Chiantella V, Johnston WE, Jolly BT, Kendricks WD, Hester TO, et al. Adjuvant N-(2-mercaptopropionyl)-glycine in blood cardioplegia does not improve myocardial protection in ischemically damaged hearts. J Thorac Cardiovasc Surg. 1990;100(1):65-76. Epub 1990/07/01.
15. Yokoyama H, Julian JS, Vinten-Johansen J, Johnston WE, Smith TD, McGee DS, et al. Postischemic [Ca2+] repletion improves cardiac performance without altering oxygen demands. Ann Thorac Surg. 1990;49(6):894-902. Epub 1990/06/01.
16. Cunningham JN, Jr., Adams PX, Knopp EA, Baumann FG, Snively SL, Gross RI, et al. Preservation of ATP, ultrastructure, and ventricular function after aortic cross-clamping and reperfusion. Clinical use of blood potassium cardioplegia. J Thorac Cardiovasc Surg. 1979;78(5):708-20. Epub 1979/11/01.
17. Opie LH. The heart: physiology, from cell to circulation: Lippincott-Raven; 1998 1998. 637 p.
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19. Kloner RA, Jennings RB. Consequences of brief ischemia: stunning, preconditioning, and their clinical implications: part 2. Circulation. 2001;104(25):3158-67. Epub 2001/12/19.
20. Follath F, Cleland JG, Just H, Papp JG, Scholz H, Peuhkurinen K, et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet. 2002;360(9328):196-202. Epub 2002/07/23.
21. Luu M, Stevenson LW, Brunken RC, Drinkwater DM, Schelbert HR, Tillisch JH. Delayed recovery of revascularized myocardium after referral for cardiac transplantation. Am Heart J. 1990;119(3 Pt 1):668-70. Epub 1990/03/01.
22. Greenberg B, Borghi C, Perrone S. Pharmacotherapeutic approaches for decompensated heart failure: a role for the calcium sensitiser, levosimendan? Eur J Heart Fail. 2003;5(1):13-21. Epub 2003/02/01.
23. Alvarez J, Bouzada M, Fernandez AL, Caruezo V, Taboada M, Rodriguez J, et al. [Hemodynamic effects of levosimendan compared with dobutamine in patients with low cardiac output after cardiac surgery]. Rev Esp Cardiol. 2006;59(4):338-45. Epub 2006/05/20. Comparacion de los efectos hemodinamicos del levosimendan con la dobutamina en pacientes con bajo gasto despues de cirugia cardíaca.
24. Levin RL, Degrange MA, Porcile R, Salvagio F, Blanco N, Botbol AL, et al. [The calcium sensitizer levosimendan gives superior results to dobutamine in postoperative low cardiac output syndrome]. Rev Esp Cardiol. 2008;61(5):471-9. Epub 2008/05/09. Superioridad del sensibilizante al calcio levosimendan comparado con dobutamina en el sindrome de bajo gasto cardíaco postoperatorio.
25. Garcia Gonzalez MJ, Dominguez Rodriguez A. Pharmacologic treatment of heart failure due to ventricular dysfunction by myocardial stunning: potential role of levosimendan. Am J Cardiovasc Drugs. 2006;6(2):69-75. Epub 2006/03/25.
26. Raja SG, Rayen BS. Levosimendan in cardiac surgery: current best available evidence. Ann Thorac Surg. 2006;81(4):1536-46. Epub 2006/03/28.
27. Lilleberg J, Nieminen MS, Akkila J, Heikkila L, Kuitunen A, Lehtonen L, et al. Effects of a new calcium sensitizer, levosimendan, on haemodynamics, coronary blood flow and myocardial substrate utilization early after coronary artery bypass grafting. Eur Heart J. 1998;19(4):660-8. Epub 1998/05/23.
2. Eslava-Schmalbach JH, Rincón CJ, Guarnizo CC. “Inequidad” de la expectativa de vida al nacer por sexo y “departamentos” de Colombia. Biomédica; Vol 33, núm 3 (2013). doi: 10.7705/biomedica.v33i3.811.
3. Delgado JF. [Levosimendan in acute heart failure: past, present and future]. Rev Esp Cardiol. 2006;59(4):309-12. Epub 2006/05/20. Levosimendan en la insuficiencia cardíaca aguda: pasado, presente y futuro.
4. Breisblatt WM, Stein KL, Wolfe CJ, Follansbee WP, Capozzi J, Armitage JM, et al. Acute myocardial dysfunction and recovery: a common occurrence after coronary bypass surgery. J Am Coll Cardiol. 1990;15(6):1261-9. Epub 1990/05/01.
5. Pollesello P, Mebazaa A. ATP-dependent potassium channels as a key target for the treatment of myocardial and vascular dysfunction. Curr Opin Crit Care. 2004;10(6):436-41. Epub 2004/12/24.
6. Garlid KD, Dos Santos P, Xie ZJ, Costa AD, Paucek P. Mitochondrial potassium transport: the role of the mitochondrial ATP-sensitive K(+) channel in cardiac function and cardioprotection. Biochim Biophys Acta. 2003;1606(1-3):1-21. Epub 2003/09/26.
7. Malliotakis P, Xenikakis T, Linardakis M, Hassoulas J. Haemodynamic effects of levosimendan for low cardiac output after cardiac surgery: a case series. Hellenic J Cardiol. 2007;48(2):80-8. Epub 2007/05/11.
8. Nashef SAM. European system for cardiac operative risk evaluation (EuroSCORE). European Journal of Cardio - Thoracic Surgery. 1999;16(1):4.
9. Mangano DT. Biventricular function after myocardial revascularization in humans: deterioration and recovery patterns during the first 24 hours. Anesthesiology. 1985;62(5):571-7. Epub 1985/05/01.
10. Tamargo J, Lopez-Sendon J. [Rationale and clinical evidence for the effects of new pharmacological treatments for heart failure]. Rev Esp Cardiol. 2004;57(5):447-64. Epub 2004/05/21. Bases y evidencias clinicas de los efectos de los nuevos tratamientos farmacologicos en la insuficiencia cardíaca.
11. Moiseyev VS, Poder P, Andrejevs N, Ruda MY, Golikov AP, Lazebnik LB, et al. Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN). Eur Heart J. 2002;23(18):1422-32. Epub 2002/09/05.
12. Benlolo S, Lefoll C, Katchatouryan V, Payen D, Mebazaa A. Successful use of levosimendan in a patient with peripartum cardiomyopathy. Anesth Analg.2004;98(3):822-4, table of contents. Epub 2004/02/26.
13. Cheung EH, Arcidi JM, Jr., Dorsey LM, Vinten-Johansen J, Hatcher CR, Jr., Guyton RA. Reperfusion of infarcting myocardium: benefit of surgical reperfusion in a chronic model. Ann Thorac Surg. 1989;48(3):331-8. Epub 1989/09/01.
14. Vinten-Johansen J, Chiantella V, Johnston WE, Jolly BT, Kendricks WD, Hester TO, et al. Adjuvant N-(2-mercaptopropionyl)-glycine in blood cardioplegia does not improve myocardial protection in ischemically damaged hearts. J Thorac Cardiovasc Surg. 1990;100(1):65-76. Epub 1990/07/01.
15. Yokoyama H, Julian JS, Vinten-Johansen J, Johnston WE, Smith TD, McGee DS, et al. Postischemic [Ca2+] repletion improves cardiac performance without altering oxygen demands. Ann Thorac Surg. 1990;49(6):894-902. Epub 1990/06/01.
16. Cunningham JN, Jr., Adams PX, Knopp EA, Baumann FG, Snively SL, Gross RI, et al. Preservation of ATP, ultrastructure, and ventricular function after aortic cross-clamping and reperfusion. Clinical use of blood potassium cardioplegia. J Thorac Cardiovasc Surg. 1979;78(5):708-20. Epub 1979/11/01.
17. Opie LH. The heart: physiology, from cell to circulation: Lippincott-Raven; 1998 1998. 637 p.
18. Kevin LG, Novalija E, Stowe DF. Reactive oxygen species as mediators of cardiac injury and protection: the relevance to anesthesia practice. Anesth Analg.2005;101(5):1275-87. Epub 2005/10/26.
19. Kloner RA, Jennings RB. Consequences of brief ischemia: stunning, preconditioning, and their clinical implications: part 2. Circulation. 2001;104(25):3158-67. Epub 2001/12/19.
20. Follath F, Cleland JG, Just H, Papp JG, Scholz H, Peuhkurinen K, et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet. 2002;360(9328):196-202. Epub 2002/07/23.
21. Luu M, Stevenson LW, Brunken RC, Drinkwater DM, Schelbert HR, Tillisch JH. Delayed recovery of revascularized myocardium after referral for cardiac transplantation. Am Heart J. 1990;119(3 Pt 1):668-70. Epub 1990/03/01.
22. Greenberg B, Borghi C, Perrone S. Pharmacotherapeutic approaches for decompensated heart failure: a role for the calcium sensitiser, levosimendan? Eur J Heart Fail. 2003;5(1):13-21. Epub 2003/02/01.
23. Alvarez J, Bouzada M, Fernandez AL, Caruezo V, Taboada M, Rodriguez J, et al. [Hemodynamic effects of levosimendan compared with dobutamine in patients with low cardiac output after cardiac surgery]. Rev Esp Cardiol. 2006;59(4):338-45. Epub 2006/05/20. Comparacion de los efectos hemodinamicos del levosimendan con la dobutamina en pacientes con bajo gasto despues de cirugia cardíaca.
24. Levin RL, Degrange MA, Porcile R, Salvagio F, Blanco N, Botbol AL, et al. [The calcium sensitizer levosimendan gives superior results to dobutamine in postoperative low cardiac output syndrome]. Rev Esp Cardiol. 2008;61(5):471-9. Epub 2008/05/09. Superioridad del sensibilizante al calcio levosimendan comparado con dobutamina en el sindrome de bajo gasto cardíaco postoperatorio.
25. Garcia Gonzalez MJ, Dominguez Rodriguez A. Pharmacologic treatment of heart failure due to ventricular dysfunction by myocardial stunning: potential role of levosimendan. Am J Cardiovasc Drugs. 2006;6(2):69-75. Epub 2006/03/25.
26. Raja SG, Rayen BS. Levosimendan in cardiac surgery: current best available evidence. Ann Thorac Surg. 2006;81(4):1536-46. Epub 2006/03/28.
27. Lilleberg J, Nieminen MS, Akkila J, Heikkila L, Kuitunen A, Lehtonen L, et al. Effects of a new calcium sensitizer, levosimendan, on haemodynamics, coronary blood flow and myocardial substrate utilization early after coronary artery bypass grafting. Eur Heart J. 1998;19(4):660-8. Epub 1998/05/23.