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

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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.

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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

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Acknowledgments

The authors would like to thank Biykem Bozkurt for critical reading of the manuscript.

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Authors and Affiliations

  1. Department of Cardiology, Haydarpaşa Numune Education and Research Hospital, Bankalar Caddesi, Horoz Apt, 4/5, Cevizli/Kartal, Istanbul, Turkey

    Murat Biteker

  2. Department of Cardiology, Kosuyolu Kartal Heart Education and Research Hospital, Istanbul, Turkey

    Nilüfer Ekşi Duran, Hasan Kaya, Sabahattin Gündüz, Halil İbrahim Tanboğa, Tayyar Gökdeniz, Gökhan Kahveci, Taylan Akgün, Mustafa Yıldız & Mehmet Özkan

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  1. Murat Biteker
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  2. Nilüfer Ekşi Duran
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  4. Sabahattin Gündüz
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  10. Mehmet Özkan
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Correspondence to Murat Biteker.

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Biteker, M., Duran, N.E., Kaya, H. et al. Effect of levosimendan and predictors of recovery in patients with peripartum cardiomyopathy, a randomized clinical trial. Clin Res Cardiol 100, 571–577 (2011). https://doi.org/10.1007/s00392-010-0279-7

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  • DOI: https://doi.org/10.1007/s00392-010-0279-7

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