The Evaluation of The Prognostic Effect of NT-Pro BNP Levels and Left Ventricular Ejection Fraction in Acute Decompansated Heart Failure During Levosimendan Treatment

Year 2009, Volume: 11 Issue: 1, 4 - 12, 01.03.2009

İbrahim Izgu Gulten Tacoy Guliz Erdem Yazıcı Yusuf Tavil Timur Tımurkaynak Deniz Demırkan

Abstract

Aim: To evaluate the prognostic effect of serum NT-proBNP levels and left ventricular ejection fraction in patients who have acute decompansated heart failure and receive levosimendan treatment. Method: Fourteen patients (10 male (71,4 %), 4 female (28,6%)) with heart failure who have low cardiac output findings and unresponsive to intravenous and vasodilator therapy, functional capacity NHYA class IV were enrolled into the study. Clinical status, systolic (SBP) and diastolic blood (DBP) pressures as hemodynamic parameters, measurements of serum NT-proBNP, BUN, Cre, Na+, K+, AST, ALT, Hb, Htc levels; left ventricular end diastolic (LVEDD) and systolic (LVESD) diameters, end diastolic (LVEDV) and end systolic (LVESV) volumes, cardiac output and ejection fraction (LVEF) by echocardiographic evaluation were obtained before and after levosimendan infusion Results: Treatment with levosimendan in decompansated heart failure exerts significantly reduction in LVEDD, LVEDV, LVESV, DBP, serum NT-proBNP levels and increase in LVEF (p

Keywords

Heart failure, levosimendan, NT-proBNP, LVEF

Akut Dekompanze Kalp Yetmezliği varlığında Levosimendan Tedavisi esnasında NT-pro BNP düzeyi ve Sol Ventrikül Ejeksiyon Fraksiyonunun Prognostik Etkisinin Değerlendirilmesi

Abstract

Amaç: Akut dekompanze kalp yetmezliği nedeniyle levosimendan tedavisi alan hastalarda serum NT-pro BNP düzeyleri ve sol ventrikül ejeksiyon fraksiyonunun prognostik öneminin araştırılması. Yöntem: NYHA sınıflamasına göre sınıf IV fonksiyonel kapasiteye sahip, intavenöz ve vazodilatör tedaviye cevap vermeyen ve düşük kardiyak debi bulgularına sahip 14 kalp yetmezliği hastası ( 10 erkek (%71.4), 4 kadın (%28.6) çalışmaya dahil edildi. Klinik durum, hemodinamik parametreler olarak sistolik (SBP) ve diastolik kan basıncı (DBP) değerleri, serum NT-pro BNP, BUN, kreatinin, Na+, K+, AST, ALT, Hb, Htc düzeyleri, ekokardiyografik olarak sol ventrikül diastol (LVEDD) ve sistol sonu çapları (LVESD) hacimleri, kardiyak debi ve ejeksiyon fraksiyonu (LVEF) parametreleri levosimendan tedavisi öncesi ve sonrasında elde edilerek karşılaştırıldı. Bulgular: Dekompanze kalp yetmezliği varlığında, levosimendan tedavisi sol ventrikül diastol sonu çapı ve hacmi, sol ventrikül sistol sonu hacmi, diastolik kan basıncı, serum NT-pro BNP düzeylerinde belirgin azalmaya ve sol ventrikül ejeksiyon fraksiyonunda artmaya neden olmuştur (p< 0.05). NT-pro BNP düzeyi ile sol ventrikül EF arasında anlamlı ters ilişki varlığı ortaya konmuştur (p

Keywords

Kalp yetmezliği, levosimendan, NT-pro BNP, ejeksiyon fraksiyonu

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