Intravenous levosimendan in patients with Takotsubo cardiomyopathy significantly improved left ventricular ejection fraction from 28% at admission to 51% at discharge (P<0.001).
Observational (n=13)
Does intravenous levosimendan improve LV function and demonstrate safety in patients with Takotsubo cardiomyopathy and low ejection fraction?
Intravenous levosimendan administration appears safe and feasible in patients with Takotsubo cardiomyopathy and severe systolic dysfunction, and is associated with significant LVEF recovery by discharge.
Tasa de eventos absoluta: 51% vs 28%
valor p: p=<0.001
BACKGROUND: Levosimendan is a noncatecholamine inotrope that does not increase oxygen consumption, utilized for the treatment for acute heart failure with left ventricular (LV) systolic dysfunction. Its use in takotsubo cardiomyopathy (TTC), a disease that contraindicates the use of catecholamine inotropes, is not well known. METHODS: We prospectively analyzed 13 consecutive patients with TTC, low ejection fraction (EF) (<35%), and additional Mayo Clinic risk factors who were treated with i.v. infusion of levosimendan. Clinical course of patients, electrocardiogram presentation, LV function, and adverse events at follow-up were recorded. RESULTS: All patients showed an impaired LV function (LVEF at admission 28 ± 5%), which significantly improved at discharge (51 ± 8%, P < 0.001). Mean hospital stay was 10 ± 4 days. Troponin levels at admission were directly related to length of hospitalization (r = 0.6, P < 0.001). Male gender (relative risk (RR) 1.85, P < 0.05), physical stress (RR 1.90, P < 0.05), ST elevation at ECG (RR 1.87, P < 0.05), and absence of chest pain (RR 2.23, P < 0.01) were found to be the predictors of longer hospital stay. Only 15% of subjects had adverse events during hospital stay; two patients incurred noncardiovascular death at follow-up. Age was the only predictor of adverse event at follow-up (RR 2.13, P < 0.05). CONCLUSIONS: The use of levosimendan may be safe and feasible in patients with TTC. Randomized studies are warranted to further confirm these preliminary results.
Santoro et al. (Sat,) conducted a observational in Takotsubo cardiomyopathy (n=13). Levosimendan was evaluated on Left ventricular ejection fraction at discharge (p=<0.001). Intravenous levosimendan in patients with Takotsubo cardiomyopathy significantly improved left ventricular ejection fraction from 28% at admission to 51% at discharge (P<0.001).