Impact of Levosimendan on High Sensitivity Cardiac Troponin-T after Valvular Heart Surgery: A Randomized Clinical Trial

Mahmoud Habib; Mohammad Torky; Amr Abdelwahab; Ehab Wahby

doi:10.35810/ects.v4i5.238

Mahmoud Habib Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
Mohammad Torky Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
Amr Abdelwahab Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
Ehab Wahby Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt

DOI: https://doi.org/10.35810/ects.v4i5.238

Keywords: Levosimendan, High Sensitivity Cardiac Troponin T, Valvular Heart Surgery

Abstract

Background: Various measures have been used for maintaining adequate cardiac output after valvular heart surgery. The study aimed to evaluate the impact of levosimendan on high-sensitivity cardiac troponin-T after valvular heart surgery.

Methods: This prospective randomized clinical trial included 400 patients. All patients above 18 years who underwent elective cardiac valvular surgery were randomly classified into two equal groups. Group A (n= 200) included patients who received levosimendan during weaning from cardiopulmonary bypass, and Group B (n= 200) included patients who did not receive levosimendan.

Results: Cardiopulmonary bypass, cross-clamp, reperfusion times, and use of inotropes were insignificant between groups. Troponin levels on days 0, 1, and 2 showed a significant decrease in Group A (P˂0.001). Postoperative ejection fraction was significantly higher in Group A (66.10 ± 4.41 vs. 46.60 ± 3.98; P˂0.001). Duration of mechanical ventilation (4.70± 1.16 vs. 10.70± 0.82; P˂ 0.001), intensive care (1.90 ± 0.57 vs. 5.90 ± 1.29; P˂0.001), and hospital stay (6.90 ± 1.91 vs. 13.40 ± 3.10; P˂0.001) were significantly lower in Group A.

Conclusions: Levosimendan could have cardioprotective effects, resulting in a significant reduction of postoperative high sensitivity cardiac troponin-T release after valvular heart surgery. It could be associated with improved left ventricular ejection fraction, short duration of mechanical ventilation, ICU, and hospital stay.