What is the clinical evidence from this study?

Study design: Cohort. Population: Takotsubo cardiomyopathy (n=42). Intervention: Levosimendan vs. Standard care without levosimendan. Primary outcome: Time to rise in left ventricular ejection fraction above 50% (days) (p=0.001).

December 2, 2016Open Access

Levosimendan accelerates recovery in patients with takotsubo cardiomyopathy

Key Result

Levosimendan significantly reduced the time to left ventricular ejection fraction recovery above 50% (8.3 vs. 10.8 days) compared to standard care in patients with takotsubo cardiomyopathy.

Study Design

Type

Cohort (n=42)

Multicenter

Yes

Structured PICO

Does levosimendan accelerate recovery in patients with takotsubo cardiomyopathy and LVEF ≤ 35%?

Population

42 consecutive patients with takotsubo cardiomyopathy (TC) having left ventricular ejection fraction (LVEF) ≤ 35%, treated across 6 cardiovascular centers in Turkey.

Intervention

Levosimendan administered as a loading dose followed by continuous intravenous infusion (n=17).

Comparator

Standard care without levosimendan (n=25).

Outcome

Recovery period, defined as the interval to achieve a 50% increase in LVEF, time to achieve baseline troponin values, and hospitalization duration.surrogate

Intravenous levosimendan may accelerate left ventricular functional recovery and reduce hospitalization time in patients with takotsubo cardiomyopathy complicated by severe systolic dysfunction.

Main Result

Absolute Event Rate: 8.3% vs 10.8%

p-value: p=0.001

Limitations

Small number of patients
Retrospective nature

Abstract

BACKGROUND: The aim of this study was to determine the efficacy and safety of levosimendan in takotsubo cardiomyopathy (TC). METHODS: The study was conducted in a retrospective design and 42 consecutive patients were enrolled in 6 cardiovascular centers in Turkey. The records of TC patients having left ventricular ejection fraction (LVEF) £ 35% were examined at admission, discharge and recovery period including their clinical and echocardiographic data. RESULTS: Of these 42 TC patients, 17 were treated with loading dose and i.v. infusion of levosimendan (group 1) and 25 were treated without levosimendan (group 2). Echocardiographic findings at admission and at discharge were similar and no serious complications were observed in either group. However recovery period including the interval of 50% increase in LVEF, time to achieve the baseline troponin values and hospitalization were significantly lower in patients taking levosimendan. CONCLUSIONS: This is the first study using loading dose and subsequent continuous intravenous administration of levosimendan demonstrating accelerated recovery in patients with TC.

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