title: [Efficacy of levosimendan vs dopamine in patients with resistant cardiac failure].
abstract: OBJECTIVE
  Effects of levosimendan treatment compared to dopamine treatment on a clinical course, central hemodynamics and prognosis in patients with resistant cardiac failure (RCF).
  
  
  METHODS
  A total of 30 RCF patients (16 females and 14 males aged 50-80 years) were divided into two groups. Patients of group 1 received inotropic drug levosimendan intravenously in the initial dose 12-24 mcg/kgfor 10 min with subsequent 24-hour infusion in a dose 0.1 mcg/kg/min. Patients of group 2 received dopamine intravenously for 24 hours in a mean dose 2.2 mcg/kg/min. The patients were followed up for 6 months.
  
  
  RESULTS
  In group 1 cardiac failure regressed earlier than in group 2. Left ventricular performance index after infusion hour 1 increased from 2.9 to 3.3 (kg.m)/m2, in group 2 it decreased from 2.6 to 2.3 (kg.m)/m2; p = 0.028). To infusion hour 24 this index in group 1 was 3.2 (kg.m)/m2, in group 2--2.6 (kg.m)/m2. Cardiac index (CI) in group 1 increased from 23 l/min/m2 at infusion min 1 to 2.7 l/min/ m2 after 10 min of infusion and 29 l/min/m2 after 24 hours, i.e. there was a 26% rise (p = 0.025). In group 2 the CI rise was insignificant--from 2.4 to 2.5 l/min/m2. To the end of levosimendan injection, systemic vascular resistance fell from 1520.9 to 1174.6 dyne.s.cm(-5) (p = 0.031), in group 2 no significant changes were seen. Hospital mortality in group 1 was 1 patient, in group 2--6 patients.
  
  
  CONCLUSIONS
  Inotropic treatment in RCF patients with levosimendan vs dopamine produces earlier regress of cardiacfailure symptoms, better improvement of myocardial contractivity, is associated with a good prognosis.
authors.forename: N A
authors.initials: NA
authors.lastname: Dzhaiani
authors.forename: I V
authors.initials: IV
authors.lastname: Kositsyna
authors.forename: N A
authors.initials: NA
authors.lastname: Gnidkina
authors.forename: S N
authors.initials: SN
authors.lastname: Tereshchenko
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004298:Dopamine / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004298:Dopamine