Plasma B-type natriuretic peptide reduction predicts long-term response to levosimendan therapy in acutely decompensated chronic heart failure.
Int J Cardiol
; 139(1): 75-9, 2010 Feb 18.
Article
em En
| MEDLINE
| ID: mdl-18973957
ABSTRACT
OBJECTIVE:
We sought to identify predictors of long-term response to levosimendan therapy among patients' baseline features and treatment-induced changes in acutely decompensated chronic heart failure (ADHF).METHODS:
Ninety-eight consecutive patients [aged 64+/-10 years, New York Heart Association (NYHA) classes III-IV, left ventricular ejection fraction <35%], 69 treated with levosimendan and 29 with standard therapy, underwent a clinical, echocardiographic and biochemical assessment before and after treatment. All patients were subsequently followed for 6 months for death or rehospitalization for ADHF.RESULTS:
Compared to standard therapy, levosimendan induced a significant improvement in NYHA class (F=37.529, p<0.001), B-type natriuretic peptide (BNP, F=22.917, p<0.001), left ventricular ejection fraction (F=23.561, p<0.001), transmitral E deceleration time (DT, F=6.499, p=0.013) and E/e ratio (F=10.812, p=0.003). During follow-up, 88 of 98 patients (90%) experienced an event. Event-free survival (days alive and out of hospital) at 6 months was similar in two groups (median, 48 days, log-rank test p=0.6760). In the levosimendan group, treatment-induced percent BNP change was the best predictor of events (OR=0.970, 95% CI=0.954-0.986, p<0.001). A cut-off for BNP change of 58% predicted events with 87% sensitivity and 83% specificity. Event-free survival was longer in patients with a BNP reduction > or =58% (median, 135 versus 43 days, p=0.0001).CONCLUSION:
Treatment-induced BNP reduction is an independent predictor of 6-month outcome following levosimendan therapy in ADHF.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Piridazinas
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Cardiotônicos
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Peptídeo Natriurético Encefálico
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Insuficiência Cardíaca
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Hidrazonas
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article