title: [Pilot study of levosimendan : Effect on liver blood flow and liver function in acute decompensated heart failure].
abstract: BACKGROUND
  In a pilot study, 9 patients (39-48 years) with acute decompensated heart failure and a cardiac index (CI) of 1.9 ± 0.3 l/min/m(2) were included after exclusion of an underlying hepatic disease.
  
  
  METHODS
  The effect of levosimendan on liver blood flow and liver function was measured with the LiMON(®) system using the indocyane green plasma disappearance rate (ICG PDR).
  
  
  RESULTS
  Levosimendan (Simdax(®)) infusion resulted in a significant increase of the CI, thus, achieving normal ranges of 2.9 ± 0.9 l/min/m(2) after 4 h and 3.3 ± 1 l/min/m(2) (p = 0.003) after 24 h. ICG PDR increased from 8.2 ± 0.8 % to 10.2 + 1.8 % after 4 h and to 11.9 ± 2.9 % after 24 h (p = 0.04).
  
  
  CONCLUSIONS
  The reason for the early increase in systemic blood flow with no concomitant change in ICG PDR is not clear. A primary increase in liver blood flow with sustained low liver function might be one explanation; a low flow-mediated increased release of cytokines from liver cells with consequent deterioration of liver function is another possible explanation.
authors.affiliation: Interne Abteilung mit Intensivstation, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Österreich, kurt.lenz@bblinz.at.
authors.forename: K
authors.initials: K
authors.lastname: Lenz
authors.forename: A
authors.initials: A
authors.lastname: Gegenhuber
authors.forename: F
authors.initials: F
authors.lastname: Firlinger
authors.forename: G
authors.initials: G
authors.lastname: Lohr
authors.forename: P
authors.initials: P
authors.lastname: Piringer
mesh_terms: D000328:Adult; D000368:Aged; D002303:Cardiac Output, Low / Q000188:drug therapy; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D007208:Indocyanine Green; D007262:Infusions, Intravenous; D008099:Liver / Q000098:blood supply*; D017093:Liver Failure / Q000188:drug therapy*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011724:Pyridazines / Q000627:therapeutic use*; D012039:Regional Blood Flow / Q000187:drug effects; D000077464:Simendan
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D007208:Indocyanine Green
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