title: [Hemodynamic and efficacies of domestic levosimendan versus dobutamine in patients with acute decompensated heart failure].
abstract: OBJECTIVE
  To compare the hemodynamic effects of domestic levosimendan versus dobutamine on patients with acute decompensated heart failure (ADHF).
  
  
  METHODS
  A total of 78 ADHF patients with pulmonary capillary wedge pressure (PCWP) ≥ 15 mm Hg and cardiac index (CI) ≤ 2.5 L×min(-1)×m(-2) were enrolled into this blind, positive-controlled, randomized and multicenter study to receive 24 h intravenous levosimendan or dobutamine therapy. They were randomized into 2 groups: levosimendan and dobutamine (n = 39 each).
  
  
  RESULTS
  In the levosimendan group, the PCWP 24 h decreased significantly ((14.2 ± 7.6) vs (23.1 ± 8.1) mm Hg, P < 0.01)and CI increased significantly versus the baseline levels ((2.8 ± 0.7) L×min(-1)×m(-2) vs (2.0 ± 0.4) L×min(-1)×m(-2), P < 0.01). As compared with the dobutamine group, the change percentages versus baseline in PCWP, pulmonary arterial mean pressure (PAMP), systemic vascular resistance (SVR) at 24 h (median) decreased or increased significantly in the levosimendan group 45.5% vs 22.1% (P < 0.05); 20.8% vs 15.0% (P < 0.05); 34.5% vs 12.7% (P < 0.01); CI increased 39.8% vs 13.5% (P < 0.01). As compared with the baseline level, LVEF increased at 24 h in the levosimendan group (27.4% ± 6.1% vs 32.5% ± 8.7%, P < 0.05). Both PCWP and CI at 24 h correlated significantly with NT-proBNP at Day 3 (r = 0.31, P < 0.01; r = -0.29, P < 0.05). Dyspnea improved greatly at 24 h in the levosimendan group than that in the dobutamine group.
  
  
  CONCLUSIONS
  As compared with dobutamine, domestic levosimendan may bring about better outcomes of hemodynamics and dyspnea.
authors.affiliation: Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Yu-hui
authors.initials: YH
authors.lastname: Zhang
authors.forename: En-ming
authors.initials: EM
authors.lastname: Qing
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.forename: Rong
authors.initials: R
authors.lastname: Lü
authors.forename: Qiong
authors.initials: Q
authors.lastname: Zhou
authors.forename: Bing-qi
authors.initials: BQ
authors.lastname: Wei
authors.forename: Tao
authors.initials: T
authors.lastname: An
authors.forename: Ping
authors.initials: P
authors.lastname: Qing
authors.forename: Chang-hong
authors.initials: CH
authors.lastname: Zou
mesh_terms: D000293:Adolescent; D000328:Adult; D004280:Dobutamine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine