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Short-term effect of levosimendan on free light chain kappa and lambda levels in patients with decompensated chronic heart failure

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Abstract

To investigate the effects of levosimendan, a positive inotropic agent, on the new heart failure markers immunoglobulin free light chains kappa and lambda (FLC-κ and FLC-λ) in decompensated chronic heart failure (HF), 59 patients with New York Heart Association (NYHA) class III–IV HF were enrolled. Patients were randomized into levosimendan (n = 31) and standard HF treatment (n = 29) groups. Serum FLC-κ and FLC-λ, brain natriuretic peptide (BNP), and ejection fraction (EF) were measured before treatment and on the 5th day of treatment initiation. Forty-two percent of subjects were females (n = 25) and overall mean age was 64.1 ± 10.7 years. FLC-κ (P < 0.05) and FLC-λ (P < 0.05) were significantly decreased in the levosimendan group compared to baseline, but no difference in either marker in the standard treatment group was observed. Pre- and post-treatment FLC-κ/FLC-λ ratios in both groups were similar, whereas FLC-κ and FLC-λ levels and the FLC-κ/FLC-λ ratio showed no significant correlation with NYHA class, brain natriuretic peptide (BNP) and ejection fraction (EF) levels; and BNP and EF changes after the treatment. Symptomatic improvement in the levosimendan group according to the NYHA class was significantly better than in the standard treatment group (P = 0.044). While 55.2% of patients in the levosimendan group showed a 1-degree shift to lower NYHA classes, 10.3% showed a 2-degree decrease. In conclusion, levosimendan caused short-term hemodynamic and symptomatic improvements, with a more pronounced decrease in FLC levels in patients with advanced decompensated HF.

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Authors and Affiliations

  1. Department of Cardiology, Adana Numune Teaching and Research Hospital, Adana, Turkey

    İbrahim Halil Kurt & Kemal Yavuzer

  2. Güzelyalı Mah 81110, Sokak, No.: 7, Adana, Turkey

    İbrahim Halil Kurt & Mustafa Kemal Batur

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  1. İbrahim Halil Kurt
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  2. Kemal Yavuzer
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Correspondence to İbrahim Halil Kurt.

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Kurt, İ.H., Yavuzer, K. & Batur, M.K. Short-term effect of levosimendan on free light chain kappa and lambda levels in patients with decompensated chronic heart failure. Heart Vessels 25, 392–399 (2010). https://doi.org/10.1007/s00380-009-1216-4

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  • DOI: https://doi.org/10.1007/s00380-009-1216-4

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