POSITIVE IMPACT OF INFUSION WITH LEVOSIMENDAN ON THE ELDER PATIENTS (60-75 YEARS OLD) WITH LOWER EJECTION FRACTION OF THE LEFT VENTRICLE (< 50%) IN THE PERI-OPERATIVE PERIOD IN NON-CARDIAC SURGERY

Pre-surgery infusion with levosimendan with the rate of 0.05–0.1 mkg*kg-1 min-1 to the elder patients (60–75 years old) with lower ejection fraction of the left ventricle (less than 50%) results in its increase by 16.7% (p < 0.01), cardiac index – by 10.3% (p >< 0.01) and reduction of NT-proBNP level in blood by 24.1% (p >< 0.1) in 24 hours after the medication infusion start. The changes persist for at least 24 hours after the surgery. Key words: levosimendan, cardiac failure, peri-operative period, pre-surgery preparation, cardiac surgery, reduction of NT-proBNP level.>< 0.01), cardiac index – by 10.3% (p< 0.01) and reduction of NT-proBNP level in blood by 24.1% (p < 0.1) in 24 hours after the medication infusion start. The changes persist for at least 24 hours after the surgery. Key words: levosimendan, cardiac failure, peri-operative period, pre-surgery preparation, cardiac surgery, reduction of NT-proBNP level.>< 0.1) in 24 hours after the medication infusion start. The changes persist for at least 24 hours after the surgery.

1. Kornienko А.N., Dobrushina O.R., Zinina E.P. Prevention of cardiac complications of extracardiac surgery. Obsch. Reanimatol., 2011, vol. VII, no. 5, pp. 57-66. (In Russ.)

2. Levosimendan: guidelines, use instructions and formula. Medication encyclopedia. (In Russ.) http://www.rlsnet.ru/mnn_index_id_3192.htm

3. Demeyere R., Herrijgers P., Flameng W. Haemodynamic effects of levosimendan, a novel calcium sensitizer, in patients during weaning from cardiopulmonary bypass. Crit. Care, 2002, vol. 6, pp. 65-66.

4. Follath F., Cleland J.G., Just H. et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomized double-blind trial. Lancet, 2002, vol. 360, pp. 196-202.

5. Katsaragakis S., Kapralou A., Drimousis P. et al. Prophylactic preoperative levosimendan administration in heart failure patients undergoing elective non–cardiac surgery: A preliminary report. Hellenic. J. Cardiol., 2009, vol. 50, pp. 185-192.

6. Landoni G., Biondi-Zoccai G., Greco M. et al. Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. Crit. Care Med., 2012, vol. 40, no. 2, pp. 634-646.

7. Moiseyev V.S., Poder P., Andrejevs N. et al. Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN). Eur. Heart J., 2002, vol. 23, no. 18, pp. 1422-1432.

8. Morelli A., Ertmer C., Pietropaoli P. et al. Reducing the risk of major elective non-cardiac surgery: is there a role for levosimendan in the preoperative optimization of cardiac function?. Curr. Drug Targets, 2009, vol. 10, no. 9, pp. 863-871.

9. Nijhawan N., Nicolosi A.C., Montgomery M.W. et al. Levosimendan enhances cardiac performance after cardiopulmonary bypass: a prospective, random-ized placebo-controlled trial. J. Cardiovasc. Pharmacol., 1999, vol. 34, no. 2, pp. 219-228.

10. Pearse R.M., Moreno R.P., Bauer P. et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet, 2012, vol. 380. pp. 1059-1065.

11. Ponschab M., Hochmair N., Ghazwinian N. et al. Levosimendan infusion improves haemodynamics in elderly heart failure patients undergoing urgent hip fracture repair. Eur. J. Anaesthesiol., 2008, vol. 25, no. 8, pp. 627-633.

12. Toller W., Heringlake M., Guarracino F., et al. Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion. International Journal of Cardiology, 2015, vol. 184, pp. 323-336.