Key result
Levosimendan significantly increased cardiac output and left ventricular ejection fraction compared to placebo, with the low-dose (12 microg/kg) producing a better hemodynamic response than high-dose.
Why the study?
Does levosimendan improve hemodynamic effects in patients with good preoperative left ventricular function undergoing off-pump coronary artery bypass grafting?
RCT (n=31)
four-times masked
randomized
Does levosimendan improve hemodynamic effects in patients with good preoperative left ventricular function undergoing off-pump coronary artery bypass grafting?
p-value: p=<0.001
Low-dose levosimendan (12 microg/kg) produces beneficial hemodynamic responses, including increased cardiac output and LVEF, in patients with good preoperative LV function undergoing off-pump CABG.
Supports low-dose levosimendan to augment hemodynamics in preserved-LV off-pump CABG; extends evidence to this surgical population.
We tested the hypothesis that levosimendan produced beneficial hemodynamic effects during and after off-pump coronary artery bypass grafting in patients with good preoperative left ventricular function. Levosimendan at low dose (12 microg/kg), high dose (24 microg/kg), or placebo were administered in thirty-one patients in a randomized and four-times masked controlled study. Heart rate was not significantly different between experimental groups. Significant increases in cardiac output and left ventricular ejection fraction occurred after high-dose (P < 0.001; P = 0.006) and low-dose levosimendan (P = 0.001; P = 0.002). Both doses of levosimendan produced significant increased stroke volume and decreased systemic vascular resistance. Mean arterial pressure, pulmonary capillary wedge pressure, and left ventricular end-systolic volume were not significantly different between groups. The low-dose levosimendan produced better hemodynamic response than high-dose and may be preferable in patients undergoing off-pump coronary artery bypass grafting.
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Barišin et al. (2004) conducted an RCT in off-pump coronary artery bypass grafting (n=31). Levosimendan vs. Placebo was evaluated on hemodynamic effects including cardiac output and left ventricular ejection fraction (p=<0.001). Levosimendan significantly increased cardiac output and left ventricular ejection fraction compared to placebo, with the low-dose (12 microg/kg) producing a better hemodynamic response than high-dose.
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