Study Objective: to assess efficacy and safety of Levosimendan (LS) in patients with myocardial infarction (MI) complicated with left ventricular failure as a result of chronic cerebral ischemia (CCI).
Study Design: randomised study.
Materials and Methods. Examination included 182 patients with Q-positive MI and CCI with left ventricular ejection fraction (LVEF) of less than 40%: 149 (81.9%) males and 33 (18.1%) females aged 60.4 (53; 69) years old. Group I included 49 patients on standard therapy, and group II comprised 133 patients on LS. Subjects were examined by angioneurologist; they underwent echocardiography, colour duplex ultrasonography of brachiocephalic arteries (CDU BCA), cognitive tests, and 6-minute walk test.
Study Results. MI complications were recorded in 16 (32.7%) patients in group I and in 27 (20.3%) patients in group II. Hypotension was noted in 10 (20.4%) patients from group I and in 31 (23.3%) patients from group II; ventricular rhythm disturbances — in 15 (30.6%) and 34 (25.6%), hypokalemia — in 7 (14.3%) and 12 (9%) patients, respectively. LVEF before discharge in group I was 39.34% (37%; 43%), in group II — 44.7% (38%; 48%) (р = 0.007). Once LS was prescribed in group II, CDU BCA demonstrated 13.1% increase in internal carotid artery (ICA) diameter (р = 0.001), 25.1% increase in average blood velocity in ICA (р = 0.001); ICA resistance factor reduced by 12% (р = 0.001). Hospital admission lasted for 19.24 (17; 20) bed-days in group I and 15.21 (12; 18) bed-days in group II (р = 0.001).
Conclusion. Use of LS in MI resulting from CCI and complicated with atrial ventricular failure is safe, hemodynamically and clinically efficient and pharmacologically and economically feasible.
Contributions: Lebedeva, N.B. — study design, data interpretation and aggregation, review of critically important material, final manuscript approval; Chesnokova, L.Yu. — collection of clinical materials, statistical processing, data analysis and interpretation, thematic publications reviewing, manuscript preparation.
Conflict of interest: The authors declare that they do not have any conflict of interests.