Impact of Levosimendan on High Sensitivity Cardiac Troponin-T after Valvular Heart Surgery: A Randomized Clinical Trial

Background: Various measures have been used for maintaining adequate cardiac output after valvular heart surgery. The study aimed to evaluate the impact of levosimendan on high-sensitivity cardiac troponin-T after valvular heart surgery. Methods: This prospective randomized clinical trial included 400 patients. All patients above 18 years who underwent elective cardiac valvular surgery were randomly classified into two equal groups. Group A (n= 200) included patients who received levosimendan during weaning from cardiopulmonary bypass, and Group B (n= 200) included patients who did not receive levosimendan. Results: Cardiopulmonary bypass, cross-clamp, reperfusion times, and use of inotropes were insignificant between groups. Troponin levels on days 0, 1, and 2 showed a significant decrease in Group A (P˂0.001). Postoperative ejection fraction was significantly higher in Group A (66.10 ± 4.41 vs. 46.60 ± 3.98; P˂0.001). Duration of mechanical ventilation (4.70± 1.16 vs. 10.70± 0.82; P˂ 0.001), intensive care (1.90 ± 0.57 vs. 5.90 ± 1.29; P˂0.001), and hospital stay (6.90 ± 1.91 vs. 13.40 ± 3.10; P˂0.001) were significantly lower in Group A. Conclusions: Levosimendan could have cardioprotective effects, resulting in a significant reduction of postoperative high sensitivity cardiac troponin-T release after valvular heart surgery. It could be associated with improved left ventricular ejection fraction, short duration of mechanical ventilation, ICU, and hospital stay.