title: Evaluation of myocardial contractility determination with tissue tracking echocardiography after levosimendan infusion in patients with poor left ventricular function and hemodynamics.
abstract: BACKGROUND
  The aim of this study was to assess the effect of conventional inotropic drugs compared to levosimendan using tissue tracking echocardiography in the early postoperative period for patients with low ejection fraction undergoing coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  We prospectively analyzed 115 patients (69 male, 46 female) who planned for elective coronary artery bypass surgery with low ejection fraction, ≤% 30, from September 2012 to December 2013. Patients were divided into two groups. Levosimendan was used at a loading dose of 15 μg/kg/min for the first twenty minutes, and continued at a maintenance dose of 0.2 μg/kg/min six hours before the anesthetic induction in group I (n = 47, 23 male, mean age 67.16 ± 4.72 years). Dopamine at 10 μg/kg/min and/or dobutamine at 10 μg/kg/min were used at the time of weaning from cardiopulmonary bypass in group II (n = 68, 47 male, mean age 65.43 ± 6.12 years). The patients were evaluated preoperatively and on the fifth postoperative day by transthoracic echocardiography. Patients were also evaluated just before the cardiopulmonary bypass and at the 12th and 24th hours on the first postoperative day by transesophageal echocardiography. Student t test and χ2 test were used for statistical analyses.
  
  
  RESULTS
  There were no significant differences in demographics and preoperative hemodynamic parameters between groups I and II. Hemodynamic and echocardiographic parameters were significantly better in group I receiving levosimendan, compared to group II.
  
  
  CONCLUSIONS
  Levosimendan enhances functional myocardial tissue mass and ensures positive hemodynamic effect in the early postoperative period in patients with low ejection fraction undergoing elective CABG.
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Veysel
authors.initials: V
authors.lastname: Sahin
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Ihsan Sami
authors.initials: IS
authors.lastname: Uyar
authors.affiliation: Division of Cardiology, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Gul
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Mehmet Besir
authors.initials: MB
authors.lastname: Akpinar
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Ahmet Feyzi
authors.initials: AF
authors.lastname: Abacilar
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Uc
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Faik Fevzi
authors.initials: FF
authors.lastname: Okur
authors.affiliation: Division of Cardiology, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Talat
authors.initials: T
authors.lastname: Tavli
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ates
authors.affiliation: Division of Cardiac Surgery, Sifa University Medical Faculty, Izmir, Turkey.
authors.forename: Emin Alp
authors.initials: EA
authors.lastname: Alayunt
mesh_terms: D002316:Cardiotonic Agents / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods; D005260:Female; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011724:Pyridazines / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000077464:Simendan; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan