Facilitation of left ventricular function recovery post percutaneous coronary intervention by levosimendan

Abstract Background Efficiency of percutaneous revascularization and the utility of levosimendan for advanced ischemic heart failure (HF) is unclear. We examined the efficacy of revascularization and levosimendan on left ventricular ejection fraction (LVEF) and mortality of patients admitted with acute decompensated HF and severe left ventricular dysfunction. Methods A prospective case control study that enrolled 84 patients with ischemic decompensated HF with LVEF Results LVEF increased in group A from 22±5 to 29±5% post PCI and continued to improve at the 6month follow-up (36±4%). In group B1 LVEF did not improve after PCI, but increased after levosimendan from 23±4% to 32±4% and remained constant at 6months. In group B2 LVEF 26±4% did not change following both interventions. Reverse remodeling with a decrease in end-diastolic and end-systolic diameters was observed only in groups A and B1. Group B2 had a dismal prognosis with 36% in-hospital and 43% six month mortality. Groups A and B1 had a lower in hospital (4.7%, 4.5%) and mid term (11%, 11%) mortality. Conclusion Improvement of LV size and function with better prognosis can be expected in the majority of patients undergoing PCI for decompensated ischemic HF. Levosimendan enhanced the recovery of LV function post PCI.