title: Levosimendan reduces plasma B-type natriuretic peptide and interleukin 6, and improves central hemodynamics in severe heart failure patients.
abstract: BACKGROUND
  Plasma B-type natriuretic peptide (BNP) and interleukin 6 (IL-6) levels have recently been demonstrated as significant neurohormonal markers associated with the progression of chronic heart failure (CHF). Additionally, clinical studies have shown that the calcium sensitizer, levosimendan, beneficially affects the central hemodynamics of CHF patients and improves their long-term prognosis. This study investigates whether levosimendan-induced hemodynamic improvement of CHF patients is related to the respective changes of NT-proBNP and IL-6 levels.
  
  
  METHODS
  Circulating levels of NT-pro BNP and IL-6 were measured by enzyme-linked immunosorbent assay (ELISA) in 12 patients with decompensated advanced CHF at baseline, immediately after the end of a 24-h levosimendan infusion and 72 h after the initiation of treatment. Hemodynamic parameters of patients (pulmonary wedge and pulmonary artery pressure (PAP), systemic and pulmonary vascular resistance (PVR), stroke volume, and cardiac output and index) were also monitored during the same period.
  
  
  RESULTS
  NT-proBNP and IL-6 levels were significantly reduced in severe CHF patients within 72 h after the initiation of levosimendan treatment (p<0.01 and p<0.05, respectively). A significant reduction of pulmonary wedge (p<0.01) and artery pressure values (p<0.05) was also found during the same period. A good correlation between the levosimendan-induced changes in NT-proBNP levels and the respective reduction of pulmonary wedge pressure (r(s)=0.65, p<0.05) was observed.
  
  
  CONCLUSIONS
  Our results indicate that changes of NT-pro BNP and IL-6 levels may be useful biochemical markers related with the levosimendan-induced improvement in central hemodynamics and the clinical status of decompensated advanced CHF patients.
authors.affiliation: Second Department of Cardiovascular Medicine and Laboratory of Molecular Immunology and Histocompatibility, Onassis Cardiac Surgery Center, Maroussi, Athens 15122, Greece.
authors.forename: Stamos
authors.initials: S
authors.lastname: Kyrzopoulos
authors.forename: Stamatis
authors.initials: S
authors.lastname: Adamopoulos
authors.forename: John T
authors.initials: JT
authors.lastname: Parissis
authors.forename: John
authors.initials: J
authors.lastname: Rassias
authors.forename: George
authors.initials: G
authors.lastname: Kostakis
authors.forename: Efstathios
authors.initials: E
authors.lastname: Iliodromitis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Degiannis
authors.forename: Dimitrios Th
authors.initials: DT
authors.lastname: Kremastinos
mesh_terms: D000368:Aged; D002316:Cardiotonic Agents / Q000494:pharmacology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006835:Hydrazones / Q000494:pharmacology*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011724:Pyridazines / Q000494:pharmacology*; D000077464:Simendan
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D015850:Interleukin-6; D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; D011724:Pyridazines; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000077464:Simendan