Perioperative Application of Levosimendan Optimizes Postoperative Renal Function and Organ Perfusion in Patients with Severe Heart Failure

Renal dysfunction and impaired organ perfusion are common concerns following cardiac surgery. Levosimendan, a calcium sensitizer inotropic drug, is investigated in this study for its potential to improve postoperative renal function and organ perfusion in patients with low preoperative ejection frac...

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Published in:Journal of cardiovascular development and disease 2023-07, Vol.10 (7), p.312
Main Authors: Leivaditis, Vasileios, Dahm, Manfred, Papaporfyriou, Anastasia, Galanis, Michail, Koletsis, Efstratios, Charokopos, Nikolaos, Ehle, Benjamin, Papatriantafyllou, Athanasios, Haussmann, Erich, Kaplunov, Vladislav, Grapatsas, Konstantinos
Format: Article
Language:English
Subjects:
Aprotinin
C-reactive protein
cardiac injury
Cardiac patients
cardiac surgery
Cardiology
Care and treatment
Consent
Creatinine
Heart failure
Heart surgery
Hemodynamics
Hospitals
Kidney diseases
levosimendan
Magnetic resonance imaging
Metabolism
Mortality
organ and tissue perfusion
Patients
renal insufficiency
Statistical analysis
Survival analysis
Tranexamic acid
Ultrasonic imaging
Vascular surgery
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Summary:Renal dysfunction and impaired organ perfusion are common concerns following cardiac surgery. Levosimendan, a calcium sensitizer inotropic drug, is investigated in this study for its potential to improve postoperative renal function and organ perfusion in patients with low preoperative ejection fraction and severe myocardial dysfunction after cardiac surgery. A retrospective analysis was conducted on 314 patients with preoperative heart failure who underwent cardiac surgery. Among them, 184 patients received perioperative adjunctive therapy with levosimendan, while 130 patients with similar characteristics received conventional treatment. The perioperative administration of levosimendan resulted in a significantly lower need for renal replacement therapy ( < 0.001) and improvements in the serum creatinine levels, glomerular filtration rate, and creatinine clearance. Similarly, the C-reactive protein levels, blood pH, and lactic acid levels showed comparable improvements. The use of levosimendan was associated with a significant enhancement in postoperative renal function and a reduction in the need for renal replacement therapy. Furthermore, it resulted in a decrease in the extent of organ malperfusion. Postoperative inflammatory reactions and metabolic balance also exhibited improvements.
ISSN:2308-3425
2308-3425
DOI:10.3390/jcdd10070312