[Hemodynamic and efficacies of domestic levosimendan versus dobutamine in patients with acute decompensated heart failure].

OBJECTIVE: To compare the hemodynamic effects of domestic levosimendan versus dobutamine on patients with acute decompensated heart failure (ADHF).
METHODS: A total of 78 ADHF patients with pulmonary capillary wedge pressure (PCWP) ≥ 15 mm Hg and cardiac index (CI) ≤ 2.5 L×min(-1)×m(-2) were enrolled into this blind, positive-controlled, randomized and multicenter study to receive 24 h intravenous levosimendan or dobutamine therapy. They were randomized into 2 groups: levosimendan and dobutamine (n = 39 each).
RESULTS: In the levosimendan group, the PCWP 24 h decreased significantly ((14.2 ± 7.6) vs (23.1 ± 8.1) mm Hg, P < 0.01)and CI increased significantly versus the baseline levels ((2.8 ± 0.7) L×min(-1)×m(-2) vs (2.0 ± 0.4) L×min(-1)×m(-2), P < 0.01). As compared with the dobutamine group, the change percentages versus baseline in PCWP, pulmonary arterial mean pressure (PAMP), systemic vascular resistance (SVR) at 24 h (median) decreased or increased significantly in the levosimendan group 45.5% vs 22.1% (P < 0.05); 20.8% vs 15.0% (P < 0.05); 34.5% vs 12.7% (P < 0.01); CI increased 39.8% vs 13.5% (P < 0.01). As compared with the baseline level, LVEF increased at 24 h in the levosimendan group (27.4% ± 6.1% vs 32.5% ± 8.7%, P < 0.05). Both PCWP and CI at 24 h correlated significantly with NT-proBNP at Day 3 (r = 0.31, P < 0.01; r = -0.29, P < 0.05). Dyspnea improved greatly at 24 h in the levosimendan group than that in the dobutamine group.
CONCLUSION: As compared with dobutamine, domestic levosimendan may bring about better outcomes of hemodynamics and dyspnea.

RCT Entities:   Population Interventions Outcomes