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Levosimendan May Offer Superior Treatment of Right Heart Failure Compared With Dobutamine: Presented at HFSA
Levosimendan treatment could potentially confer better therapeutic effects in right-ventricular function (RVF) compared with dobutamine, researchers reported here at the 11th Annual Scientific Meeting of the Heart Failure Society of America (HFSA).
Decreased RVF and acute heart failure (AHF) can occur simultaneously, resulting in hepatic congestion and increased levels of major hepatic enzymes. Treatment with levosimendan improves the circulating levels of enzymatic markers associated with hepatic congestion.
Cardiovascular Clinical Researcher Robert J. Padley, MD, Abbott Laboratories, Abbott Park, Illinois, United States, reported findings from Survival Of Patients With Acute Heart Failure In Need Of Intravenous Inotropic Support (SURVIVE), a large prospective, randomised, controlled trial, on behalf of his colleagues at Hospital Lariboisiere, Paris, France and Athens University Hospital Attikon, Athens, Greece.
The effect of levosimendan on RVF, compared to dobutamine, was indirectly assessed, noted Dr. Hadley, by examining changes in the levels of aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase (AP) in subjects from the SURVIVE trial.
For all 664 patients treated with levosimendan as well as the 663 patients that received treatment with dobutamine, hepatic status was assessed at baseline and at 1, 3, and 5 days, using the AST, ALT, and AP enzymatic levels; gamma glutamyl transferase, bilirubin, albumin, prothrombin time, or cholesterol were not routinely collected in the SURVIVE trial.
For all subjects, changes in enzyme levels of AST, ALT, and AP were determined using the analysis of covariance model, with treatment and baseline serving as covariates.