Effect of Levosimendan on the Prognosis of Cardiac Surgery in Patients with Cardiac Insufficiency
Abstract
Heya Na, Xianen Fa, Yuyang Zhou, Xiangyang Li, Rui Zhu, Lei Liu, Bing Liu
Objective: To retrospectively analyze the effect of levosimendan on the survival and prognosis of cardiac surgery patients with LVEF<40%.
Methods: The clinical data of 224 patients with preoperative LVEF<40% were retrospectively analyzed. According to different treatment schemes, the patients were divided into levosimendan group (n=60) and non-levosimendan group (n=164). The control group was treated with routine treatment, and the observation group was treated with levosimendan on the basis of routine treatment. Then a multivariate logistic regression model with a propensity score analysis was used to limit biases and finally the data of 40 patients in each group were selected for analysis.
Results: Hemodynamic data showed that the cardiac index, LVEF and PAOP of patients in levosimendan group were significantly improved. The concentration of serum lactic acid in the levosimendan group was lower than that in the control group (P<0.05). At the same time, postoperative ICU and hospital stay were significantly reduced in levosimendan group (P<0.05), Logistics regression analysis showed that levosimendan was the only protective factor for Low cardiac output syndrome (LCOS) (HR=4.33; 95% confidence interval: 1.27-14.78; P=0.019).
Conclusion: Levosimendan can better improve hemodynamics and reduce postoperative ICU time and hospital stay. The use of it tends to decrease the incidence of LCOS significantly.