Effect of levosimendan inotropic stimulation on hemodynamic parameters and heart rhythm variability in the combination treatment of heart failure depending on patient age
Urgency. Prevalence and frequency of hospitalization for heart failure (HF), especially due to IHD in elderly patients remain high. Information about the efficacy of inotropic stimulators, particularly the representative of a new class, the calcium sensitizer levosimendan is available. However studies of levosimendan combinations with β-adrenoblockers, ACEI and diuretics in patients including elderly ones are absent in the literature. Aim. Role of inotropic support by levosimendan in combination with myocardial unload (by Beta-Blocker, ACEinhibitors, diuretics) on clinical signs of CHF, intracardiac hemodynamic numbers, brain arteries blood flow, and appearence of vegetative nervous system, at patients of different age groups with IHD and signs of stenotic atherosclerosis of extracranial arteries. Materials and methods. 45 patients with IHD complicated with uncontrolled HF were included in the study. All patients received levosimendan (LS). Group A (n=24) consisted of patients younger than 60 years; group В (n=21) consisted of patients older than 60 years. Patients were observed and examined during the inpatient period. Results. The treatment with LS as a part of combination therapy for IHD with signs of uncontrolled HF was equally effective in mid-aged and older patients. The treatment provided achievement of clinical control of HF, improvement of morphofunctional cardiovascular parameters and parameters of heart rhythm variability (HRV) during the inpatient period. Older patients had more considerable decreases in pulmonary artery blood pressure.