Comparing curative effects of levosimendan and dopamine in patients with severe valvular heart disease complicated by atrial fibrillation
TENG Yan-feng
WU Xuan-qin
CHEN Geng
LIU Jing-feng
CHENG Ying
CHEN Zhong-liang
Abstract：Objective To compare the application results of levosimendan and dopamine in patients with severe valvular heart disease complicated by atrial fibrillation (AF) during surgery.Methods The patients (n=68, male 43 and female 25) were chosen from the People’s Hospital of Guangming New District of Shenzhen City from Oct. 2010 to Oct 2013, and randomly divided into group A and group B (eachn=34). The patients in 2 groups were all given cardiac valve replacement/valvoplasty. Group A was given levosimendan injection immediately after anesthesia induction, and group B was given dopamine after heart resuscitation. After drug administration for 24 h, the aortic occlusion duration, duration of cardiopulmonary bypass (CPB) and length of hospital stay were recorded in 2 groups. The levels of cardiac troponin I (cTnI), creatine kinase MB (CK-MB) and brain natriuretic peptide (BNP) were detected at different time points (before surgery and 6 h, 24 h and 48 h after surgery). The changes of left ventricular ejection fraction (LVEF) was detected before and 5 d after surgery. The surgery complications and adverse reactions were recorded 1 m after surgery.Results LVEF was significantly higher in group A than that in group B [(43.0±2.3) %vs. (38.4±9.7) %] after surgery for 5 d (P<0.05). The value of cTnI was (0.40±0.17) μg/L after 24 h and (0.16±0.06)μg/L after 48 h in group A, and that was (0.57±0.18) μg/L after 24 h and (0.39±0.11) μg/L after 48 h in group B (allP<0.05). The value of BNP was (936.8±270.6) ng/L after 6 h, (750.7±305.4) ng/L after 24 h and (608.4±183.3) ng/L after 48 h in group A, and that was (1109.8±395.5) ng/L after 6 h, (866.5±311.8) ng/L after 24 h and (733.2± 201.5) ng/L after 48 h in group B (allP<0.05). The incidence of complications was significantly lower in group A than that in group B (20.59%vs. 41.18%,P<0.05), and the difference in incidence of adverse reactions had no statistical significance between 2 groups (P>0.05).Conclusion Levosimendan administrated during cardiac valve replacement/valvoplasty can effectively improve myocardial contract and reduce post-operation complications and adverse reactions compared with dopamine in patients with severe valvular heart disease complicated by AF.
Keywords：Valvular heart diseaseAtrial fibrillationDopamineLevosimendan
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 961-964 )