491 Effects of intravenous levosimendan and dobutamine on circulating pro‐inflammatory cytokines and soluble apoptosis mediators in patients with decompensated advanced heart failure

tricular dimensions, ejection fraction and end-systolic wall stress were estimated by echocardiography, while levels of IL-6, TNF-a, sFas and sFasL were determined with ELISA at baseline and immediately after the treatment. All values are expressed as means4-SEM. Results: End-systolic wall stress was significantly decreased in the levosimendan-treated group (from 7824-66 to 6614-72 gr/cm 2, p<0.05) while remained unchanged in dobutamine and placebo groups (from 7374-49 and 7224-49 to 7524-54 and 739-4-50 gr/cm 2 respectively, p=NS for both). Serum levels of IL-6, sFas and sFasL were significantly decreased in the levosimendan-treated group (from 12.74-1.6, 6.94-0.98 and 69.3:1:5.3 to 10.98 pg/ml, 5.9-4-0.99 ng/ml and 60.5:t:5.16 pg/mi respectively, p<0.05 for all) but remained unchanged in dobutamine-treated (from 12.4-1.5, 6.94-0.86 and 66.04-5.3 to 13.2 pg/ml, 7.374-0.97 ng/ml and 66.64-6.51 pg/ml respectively, p=NS for all) and placebo groups (from 10.54-1.1, 6.44-0.58 and 67.24-5.1 to 10.71 pg/ml, 5.734-0.66 ng/ml and 68.04-5.01 pg/ml respectively, p=NS for all). Serum levels of TNF-a remained unchanged in levosimendan and dobutamine-treated groups (from 11.94-1.5 and 12.94-1.7 to 11.4-t-1.91 and 12.54-1.71 pg/ml respectively, p=NS for both) while it was slightly increased in the placebo-treated group (from 12.24-1.8 to 13.14-1.91 pg/ml, p<0.05). Conclusions: Levosimendan seems to be superior than dobutamine in patients with decompensated CHF, since it decreases cardiac wall stress, it depresses the expression of pro-inflammatory cytokines, having also anti-apoptotic properties. Therefore, the beneficial effects of levosimendan on the clinical status of advanced CHF patients, may be a result of its anti-inflammatory and anti-apoptotic properties.