Abstract 2946: Additive Improvement of Systolic and Diastolic Functions by the Concomitant Administration of Levosimendan and Dobutamine in Left Ventricular Dysfunction: A Radionuclide Ventriculographic Study
Purpose: Levosimendan (LEVO) is a novel calcium sensitizing agent with positive inotropic effect. Hemodynamic effects of LEVO have been reported to begin 10 min after the administration. Although there are some studies investigated the hemodynamic efficacy of LEVO compared to dobutamine (DOB), little is known about the concomitant administration of both agents on ventricular functions. We evaluated the effects of the concomitant administration of LEVO and DOB on diastolic and systolic functions by means of radionuclide ventriculography (RNV).
Methods: The study population consisted of 39 patients with left ventricular (LV) dysfunction (ejection fraction < 0.35) confirmed by echocardiography. All patients underwent RNV and LV ejection fraction (EF), peak ejection rate (PER), time to peak ejection rate (TPER), peak filling rate (PFR), time to peak filling rate (TPFR) and mean filling rate (MFR) were used to measure for LV systolic and diastolic functions. Cardiac blood pool images were accomplished at rest (basal) and at the end of the administration of low dose DOB infusion (10 microg/kg/min) for 15 min. Subsequently, DOB was discontinued for 15 min and after than, LEVO 24 microg/kg was administered over 10 min followed by a constant infusion of 0.2 microg/kg/min for 30 min. After RNV images were obtained, DOB 10 microg/kg/min was added to LEVO infusion for 30 min and RNV was repeated.
Results: NT-proBNP levels of the study patients were 5124 ± 150 pg/ml. Systolic (EF, PER, TPER) and diastolic (PFR, TPFR, MFR) variables were found to significantly improve by the LEVO infusion and DOB infusion as compared with basal values and further improvement was observed by the concomitant administration (Table⇓, *p < 0.05, **p < 0.01 and ***p < 0.001 vs basal, †p < 0.05 vs DOB, #p < 0.05 and §p < 0.01 vs LEVO values).
Conclusions: This study suggests that the concomitant administration of LEVO and DOB further improved both systolic and diastolic functions as compared with the use of each drug alone.