Title |
Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase
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Published in |
Therapeutics and Clinical Risk Management, April 2016
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DOI | 10.2147/tcrm.s102772 |
Pubmed ID | |
Authors |
José Luis Guerrero-Orriach, Daniel Ariza-Villanueva, Ana Florez-Vela, Lourdes Garrido-Sánchez, María Isabel Moreno-Cortés, Manuel Galán-Ortega, Alicia Ramírez-Fernández, Juan Alcaide Torres, Concepción Santiago Fernandez, Isabel Navarro Arce, José María Melero-Tejedor, Manuel Rubio-Navarro, José Cruz-Mañas |
Abstract |
To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV) dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL) and neuronal enolase. This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan. Levosimendan was administered preoperatively on the day before surgery. All patients were considered high risk of cardiac and perioperative renal complications. Cardiac function was assessed by echocardiography, renal function by urinary N-GAL levels, and the acute kidney injury scale. Neuronal damage was assessed by neuron-specific enolase levels. After surgery, no significant variations were found in mean and SE levels of N-GAL (14.31 [28.34] ng/mL vs 13.41 [38.24] ng/mL), neuron-specific enolase (5.40 [0.41] ng/mL vs 4.32 [0.61] ng/mL), or mean ± SD creatinine (1.06±0.24 mg/dL vs 1.25±0.37 mg/dL at 48 hours). RV dilatation decreased from 4.23±0.7 mm to 3.45±0.6 mm and pulmonary artery pressure from 58±18 mmHg to 42±19 mmHg at 48 hours. Preoperative administration of levosimendan has shown a protective role against cardiac, renal, and neurological damage in patients with a high risk of multiple organ dysfunctions undergoing cardiac surgery. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Unknown | 4 | 100% |
Demographic breakdown
Type | Count | As % |
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Practitioners (doctors, other healthcare professionals) | 3 | 75% |
Members of the public | 1 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Italy | 1 | 6% |
Unknown | 15 | 94% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 4 | 25% |
Researcher | 3 | 19% |
Student > Bachelor | 3 | 19% |
Other | 2 | 13% |
Student > Master | 1 | 6% |
Other | 1 | 6% |
Unknown | 2 | 13% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 6 | 38% |
Decision Sciences | 1 | 6% |
Biochemistry, Genetics and Molecular Biology | 1 | 6% |
Social Sciences | 1 | 6% |
Materials Science | 1 | 6% |
Other | 0 | 0% |
Unknown | 6 | 38% |