Turk Kardiyol Dern Ars. 2006; 34(2): 84-88

The effect of levosimendan infusion on QT dispersion in patients with ischemic cardiomyopathy and acute decompensated heart failure

Hülya Akhan Kaşıkcıoğlu, Zeynep Tartan, Hüseyin Uyarel, Şennur Ünal, Ahmet Akyol, Ertan Ökmen, Recep Öztürk, Neşe Çam
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Merkezi, Kardiyoloji Bölümü, İstanbul

OBJECTIVES
Levosimendan, a calcium sensitizer, improves myocardial contractility without increasing myocardial oxygen demand. We investigated the effect of levosimendan on QT dispersion in patients with decompensated heart failure.

STUDY DESIGN
The study included 20 male patients (mean age 59±10 years; range 48 to 70 years) who were admitted with decompensated heart failure (New York Heart Association functional class III-IV). Intravenous levosimendan was administered with an initial bolus dose of 12 µg/kg for 10 min, followed by a continuous infusion of 0.1 µg/kg/min for 24 hours. Transthoracic echocardiograpy was performed and electrocardiograms were obtained before and after drug infusion. QT dispersion (QTd) was defined as the difference between the maximum (QTmax) and the minimum (QTmin) QT duration, and the value was corrected for heart rate (QTc).

RESULTS
Left ventricular ejection fraction was 35% or less in all the patients before and after the infusion. No significant differences were found before and after treatment with respect to QTmax and QTmin durations. Levosimendan administration was associated with decreased QTd (52±20 msec vs 61±24 msec, p=0.09) and QTc (63±25 msec vs 72±29 msec, p=0.11) values, without exerting a significant effect.

CONCLUSION
Our results suggest that therapeutic doses of levosimendan do not exert a negative effect on ventricular homogeneity.

Keywords: Cardiotonic agents/administration & dosage; electrocardiography; heart failure, congestive/drug therapy; hemodynamic processes/drug effects.

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