Early effects of levosimendan on LV function in patients with CCS and single vessel CTO of the LAD artery

Background and Aims

Levosimendan is a calcium-sensitizing inodilatorthat enhances myocardial contractility while reducing preload and afterload. Its early administration after successful coronary revascularization may improve left ventricular (LV) recovery.

This study aimed to evaluate the short-term effects of levosimendan on LV functional parameters in patients with chronic coronary syndrome (CCS) and single-vessel chronic total occlusion (CTO) of the left anterior descending (LAD) artery.

Methods

A total of 80 patients with CCS, single-vessel LAD CTO, and left ventricular ejection fraction (LVEF) of 40-45% were enrolled.

All patients were non-diabetic and underwent successful revascularization.

Patients were divided into two groups:

Group 1 (n=40): Standard therapy + levosimendan (0.1 pg/kg/min for 24 hours)

Group 2 (n=40): Standard therapy only.

Echocardiograpy — was assessed at baseline and after one week.

Results

After 1 week, Group 1 demonstrated a significant improvement in LV function:

LVEF: 40.8 ± 2.3 46.5 ± 2.7% (p<0.05)

EDV: 142 ± 18 132 ± 16 mL (p<0.05)

ESV: 84 ± 12 -» 70 ± 11 mL (p<0.05)

EDD: 56.4 ± 3.2 53.9 ± 3.0 mm (p<0.05)

ESD: 42.7 ± 2.9 -> 39.8 ± 2.6 mm (p<0.05)

In Group 2, changes were minimal and not statistically significant:

LVEF: 41.2 ± 2.5 -► 42.6 ± 2.8%

EDV: 140 ± 17 -» 138 ± 16 mL •ESV: 82 ± 11 -> 79 ± 12 mL

EDD: 55.9 ± 3.1 - 55.1 ± 3.0 mm

ESD: 42.3 ± 2.8 ^ 41.7 ± 2.7 mm (all p>0.05)

Conclusions

Early administration of levosimendan following successful LAD CTO revascularization in CCS patients with moderately reduced LVEF significantly improved LV functional parameters (LVEF, EDV, ESV, EDD, ESD) within one week, compared to standard therapy alone.

These findings support the role of levosimendan in promoting early myocardial recovery after revascularization.