Clinical Research in Cardiology

, Volume 100, Issue 7, pp 571–577

Effect of levosimendan and predictors of recovery in patients with peripartum cardiomyopathy, a randomized clinical trial

  • Murat Biteker
  • Nilüfer Ekşi Duran
  • Hasan Kaya
  • Sabahattin Gündüz
  • Halil İbrahim Tanboğa
  • Tayyar Gökdeniz
  • Gökhan Kahveci
  • Taylan Akgün
  • Mustafa Yıldız
  • Mehmet Özkan
Original Paper

DOI: 10.1007/s00392-010-0279-7

Cite this article as:
Biteker, M., Duran, N.E., Kaya, H. et al. Clin Res Cardiol (2011) 100: 571. doi:10.1007/s00392-010-0279-7

Abstract

Background

Levosimendan is a promising new inodilator agent but its effectiveness in peripartum cardiomyopathy (PPCM) has not been tested in a clinical trial. The authors sought to evaluate the effect of levosimendan therapy and to determine the predictors of clinical outcome in patients with PPCM.

Methods and results

The authors prospectively randomized 24 consecutive women with PPCM. Twelve patients (control group) were randomized to conventional heart failure therapy and 12 patients (levosimendan group) were randomized to levosimendan in addition to the conventional therapy. Mean follow-up period was 20.9 ± 9 months (ranged 12–38 months). The two groups did not differ in baseline demographic and echocardiographic characteristics. Eleven patients (45.8%) recovered completely (6 in control group and 5 in levosimendan group, p > 0.05), 6 died (25%) (3 in control group and 3 in levosimendan group), and 7 (29.1%) were left with persistent left ventricular dysfunction (PLVD) (3 in control group and 4 in levosimendan group, p > 0.05). There were significant differences in baseline characteristics between deceased patients and survivors including left ventricular end-diastolic diameter (7.1 ± 0.6 vs. 6.4 ± 0.5 cm, p = 0.031), left ventricular end-systolic diameter (LVESD) (6.4 ± 0.8 vs. 5.5 ± 0.6 cm, p = 0.027), left ventricular ejection fraction (LVEF) (19.7 vs. 27.4%, p = 0.025), and left atrial diameter (4.9 ± 0.3 vs. 4.3 ± 0.4 cm, p = 0.011).

Conclusions

Addition of levosimendan to conventional therapy did not improve outcome in patients with PPCM. In patients with PLVD or patients who died, LVEF, LVESD and left atrial diameter were worse than those with complete resolution.

Keywords

Levosimendan Peripartum cardiomyopathy Treatment 

Abbreviations

PPCM

Peripartum cardiomyopathy

NYHA FC

New York heart association functional class

LVEF

Left ventricular ejection fraction

PLVD

Persistent left ventricular dysfunction

LVESD

Left ventricular end-systolic diameter

LVEDD

Left ventricular end-diastolic diameter

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Murat Biteker
    • 1
  • Nilüfer Ekşi Duran
    • 2
  • Hasan Kaya
    • 2
  • Sabahattin Gündüz
    • 2
  • Halil İbrahim Tanboğa
    • 2
  • Tayyar Gökdeniz
    • 2
  • Gökhan Kahveci
    • 2
  • Taylan Akgün
    • 2
  • Mustafa Yıldız
    • 2
  • Mehmet Özkan
    • 2
  1. 1.Department of CardiologyHaydarpaşa Numune Education and Research HospitalIstanbulTurkey
  2. 2.Department of CardiologyKosuyolu Kartal Heart Education and Research HospitalIstanbulTurkey

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