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IJHSR. 2016; 6(7): 33-41


Clinical Effectiveness of Intravenous Levosimendan Therapy in the Treatment of Acute Decompensated Heart Failure and Its Effect on Anti-Inflammatory Cytokines, Pro-Inflammatory Cytokines and NT Pro BNP.

Ekrem Aksu, Gürkan Çıkım.

Abstract
Aim: Clinical effectiveness of intravenous (IV) Levosimendan therapy in the treatment of acute decompensated heart failure and its effect on anti-inflammatory cytokines; pro-inflammatory cytokines and N-terminal pro-brain natriuretic peptide (NT proBNP) were investigated.
Materials and Methods: 19 patients with diagnosis of acute decompensated heart failure in coronary intensive care unit, who has Class III or Class IV heart failure according to New York Heart Association (NYHA) with a NT proBNP level higher than 500 ng/dl and planned to treat with IV Levosimendan, was included to the study.
Results: Compared to pre-treatment baseline values it was found that left ventricular (LV) ejection fraction, LV stroke volume and anti-inflammatory interleukin-10 (IL-10) measured at 72nd hour were significantly increased; LV end-systolic volume, NT proBNP level and pro-inflammatory cytokines –interleukin 1 (IL-1), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α) were significantly decreased. There was no significant difference in complete blood count and biochemical tests. IV Levosimendan therapy in the treatment of acute decompensated heart failure provided rapid hemodynamic and symptomatic improvement. It was found that it significantly decreases pro-inflammatory cytokines which had a role in the progression of heart failure and significantly increases anti-inflammatory cytokines. Levosimendan treatment significantly decreased serum NT proBNP level which shows correlation with ventricular tension level thereby myocardial oxygen demand.
Conclusion: IV Levosimendan therapy used in the treatment of acute decompensated heart failure is an effective, reliable treatment choice which may provide positive contribution to mortality and morbidity of chronic heart failure.

Key words: Acute decompensated heart failure, levosimendan, cytokines.



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