İleri kalp yetersizliği hastalarında levosimendanın eritrosit dağılım genişliği üzerine etkisi

Year 2015, Volume: 25 Issue: 1, 14 - 17, 01.03.2015

Dursun Çayan Akkoyun Aydın Akyüz Şeref Alpsoy Murat Aydın Niyazi Güler Ahmet Gürel

https://izlik.org/JA95ZN25JP

Abstract

Amaç: Levosimendan dekompanse kalp yetersizliğinde kullanılan, olumlu hemodinamik etkileri de olan pozitif inotropik bir ilaçtır. Bu çalışmanın amacı levosimendan tedavisi almış ileri kalp yetersizliği hastalarının tedavi öncesi ve sonrası eritrosit dağılım genişliğinin RDW değişimlerini belirlemektir. Gereç ve yöntem: İleri kalp yetersizliği ile yatarak levosimendan tedavisi uygulanmış 108 hasta geriye dönük olarak tarandı. Hastaların levosimendan tedavisi öncesindeki ve bir ay sonrasındaki kontrollerinde kaydedilmiş hemogram ve ekokardiyografi verileri karşılaştırıldı. Bulgular: Sonuçlar incelendiğinde levosimendan tedavisi sonrası RDW, sol ventrikül diyastol sonu çapı ve sol ventrikül sistol sonu çapı ortalamasının, tedavi öncesinden anlamlı düzeyde azaldığı, sol ventrikül ejeksiyon fraksiyonu ortalamasının ise tedavi öncesine göre anlamlı düzeyde arttığı görüldü. Diğer özellikler üzerine tedavinin anlamlı düzeyde etki etmediği görüldü. Sonuç: Kardiyovasküler hastalıklarda prognostik önemi gösterilmiş olan eritrosit dağılım hacminin levosimendan tedavisi sonrası istatistiksel olarak anlamlı düzeyde azaldığı gösterildi. Levosimendan tedavisi almış hastalarda olumlu hemodinamik etkileri takipte, kolaylıkla ölçülebilen eritrosit dağılım genişliği fayda sağlayabilir

Keywords

Levosimendan , kalp yetersizliği , eritrosit dağılım genişliği

The effect of levosimendan treatment on red cell distribution width in advanced heart failure patients

https://izlik.org/JA95ZN25JP

Abstract

Purpose of this study is to compare the red cell distribution width RDW in advanced heart failure patients who were treated with levosimendan before and after the treatment. Material and methods: One hundred and eight advanced heart failure patients who had levosimendan treatment during hospitalization were screened retrospectively. Echocardiographic and hemogram data before and one month after the treatment were obtained from retrospective records. Values before and after the treatment were compared. Results: Mean RDW was 15.4% before the treatment and mean RDW was 15.2% after the treatment. Mean change was 0.70 and this decrease was found to be statistically significant p=0.019 . Mean left ventricular end diastolic diameter and mean left ventricular end systolic diameter were decreased significantly and mean left ventricular ejection fraction before 29,3%, after 30.3%, mean change 1,61%, p

Keywords

Levosimendan , heart failure , red cell distribution width

References

• Perkins Sl, Greer JP, Foerster J, et al. Examination of bloodand bone marroweds. Wintrobe’s Clinical Hematology. 11th ed. Salt Lake City, UT: Lippincott Williams & Wilkins; 2003:5-25.
• Lippi G, Targher G, Montagnana M, et al. Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients. Arch Pathol Lab Med 2009;133:628-32.
• Weiss G, Goodnough LT. Anemia of chronicdisease. N Engl J Med 2005;352:1011-23.
• vanKimmenade RR, Mohammed AA, Uthamalingam S, et al. Red blood cell distribution width and 1-year mortality in acute heart failure. Eur J Heart Fail 2010;12:129-36.
• Dabbah S, Hammerman H, Markiewicz W, et al. Relation between red cell distribution width and clinical outcomes after acute myo- cardial infarction. Am J Cardiol 2010;105:312-7.
• Emans ME, van der Putten K, vanRooijen KL, et al. Determinants of red cell distribution width (RDW) in cardiorenal patients: RDW is not related to erythropoietin resistance. J Card Fail. 2011;17:626- 33.
• Haikala H, Kaivola J, Nissinen E, et al. Cardiactroponin C as a tar- get protein for a novel calcium sensitizing drug, levosimendan. J Mol Cell Cardiol 1995;27:1859-66.
• Yokoshiki H, Katsube Y, Sunagawa M, et al. Levosimendan, a novel Ca2+ sensitizer, activates the glibenclamide-sensitive K+ channel in rat arterial myocytes. Eur J Pharmacol 1997;333:249-59.
• Kaheinen P, Pollesello P, Levijoki J, et al. Levosimendan increa- ses diastolic coronary flow in isolated guinea-pigheartbyopening ATP-sensitive potassium channels. J Cardiovasc Pharmacol 2001; 37:367-74.
• Erdei N, Papp Z, Pollesello P, et al. The levosimendan metabolite OR-1896 elicits vasodilation by activating the K(ATP) and BK(- Ca) channels in rat isolated arterioles. Br J Pharmacol 2006;148: 696-702.
• Parissis JT, Adamopoulos S, Antoniades C, et al. Effects of levo- simendan on circulating pro-inflammatory cytokines and soluble apoptosis mediators in patients with decompensated advanced he- art failure. Am J Cardiol 2004;93:1309–12.
• Trikas A, Antoniades C, Latsios G, et al. Long-term effects of levo- simendan infusion on inflammatory processes and sFas in patients with severe heart failure. EurJHeart Fail 2006;8:804–9.
• Kyrzopoulos S, Adamopoulos S, Parissis JT, et al. Levosimendan reduces plasma B-type natriuretic peptide and interleukin 6, and improves central hemodynamics in severe heart failure patients. Int J Cardiol 2005;99:409–13.
• McLean AS, Huang SJ, Nalos M, et al. Duration of the beneficial effects of levosimendan in decompensated heart failure as measu- red by echocardiographic indices and B-type natriuretic peptide. J Cardiovasc Pharmacol 2005;46:830–5.
• Cavusoglu Y, Tek M, Birdane A, et al. Both levosimendan and do- butamine treatments result in significant reduction of NT-proBNP levels, but levosimendan has better and prolonged neurohormonal effects than dobutamine. Int J Cardiol 2008;127:e188-91.
• Mohri M, Motohama R, Sato N. Home-based cardiac rehabilita- tion decreases red cell distribution width in chronic heartfailure. Acta Cardiol 2013;68:615-19.
• Slawsky MT, Colucci WS, Gottlieb SS, et al. Hemodynamic and neurohumoral effects of continuous infusion of levosimen- dan in patients with congestive heart failure. J Am Coll Cardiol 2000;36:1903-12.
• Duman D, Palit F, Simsek E, et al. Effects of levosimendan versus dobutamine on left atrial function in decompensated heart failure. Can J Cardiol 2009;25:e353-6.