Effectivness study of Leosimendan in the treatment of perioperative in elderly hip fracture with heart failure

doi:10.3877/cma.j.issn.2096-0263.2018.01.007

Abstract

Abstract:

Objective

To study the effect of levosimendan in the treatment of elderly heart failure patients underwent urgent hip fracture repairment.

Methods

A retrospective analysis was performed in the First Hospital of Handan from January 2013 to December 2016, including 64 (30 femoral neck fracture, 34 intertrochanteric fracture) elderly hip fractures conforming to inclusion criteria. Patients were divided into levosimendan group and control group according to the application of levosimendan, the levosimendan group had 32 cases same as the control group. The left ventricular ejection fraction (LVEF), b-type natriuretic peptide (BNP) and cardiac output (CO), cardiac index (CI) before application of levosimendanat 24 h and 7 d after surgery were compared to evaluate the curative effect of levosimendan.

Results

LVEF, CO, CI at 24 h and 7 d after syrgery in Leosimendan group were significantly higher than control group (LVEF: t=2.428, t=3.150; CI: t=3.349, t=3.777; CO: t=2.615, t=2.620, P<0.05), BNP levels at 24 h and 7 d after surgery in leosimendan group was significantly lower than the control group, with statistical significance (t=2.989, t=2.693, P<0.05).

Conclusion

Levosimendan can be used to improve heart function and prognosis of elderly hip fracture with heart failure by regulating perioperative hemodynamic index.

Key words: Hip fractures, Aged, Simendan, Heart failure

Yafeng Hao, Yuan Li, Zhiqian Wang, Wenyong Ji, Xudong Wang. Effectivness study of Leosimendan in the treatment of perioperative in elderly hip fracture with heart failure[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(01): 29-32.

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References 20

1	张国宁, 侯波, 单连成, 等. 中老年人群髋部骨折发病率调查：上海市长宁区数据分析[J]. 中国组织工程研究, 2015 (37): 6055-6059.
2	Haentjens P, Magaziner J, Colón-Emeric CS, et al. Meta-analysis: excess mortality after hip fracture among older women and men [J]. Ann Intern Med, 2010, 152(6): 380-390.
3	Trpeski S, Kaftandziev I, Kjaev A. The effects of time-to-surgery on mortality in elderly patients following hip fractures [J]. Prilozi, 2013, 34(2): 116-121.
4	张英泽. 老年股骨颈骨折诊治中的重要问题[J/CD]. 中华老年骨科与康复电子杂志, 2015, 1(1): 6-8.
5	Ng TM. Levosimendan,a new calcium-sensitizing inotrope for heart failure[J]. Pharmacotherapy, 2004, 24(10): 1366-1384.
6	Barisin S, Husedzinovic I, Sonicki Z, et al. Levosimendan in off-pump coronary arterybypass [J]. J Cardiovasc Pharmacol, 2004, 44(6): 703-708.
7	Nijhawan N, Nikolosi AC, Montgomery MW, et al. Levosimendan enhances cardiacperformance after cardiopulmonary bypass: a prospective, randomized placebo-controlled trial [J]. J Cardiovasc Pharmacol, 1999, 34(2): 219-228.
8	Roche JJ, Wenn RT, Sahota O, et al. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study [J]. BMJ, 2005, 331(7529): 1374.
9	Toller WG, Metzler H. Acute perioperative heart failure [J]. Curr Opin Anaesthesiol, 2005, 18(2): 129-135.
10	Hernandez AF, Whellan DJ, Stroud S, et al. Outcomes in heart failure patients after major noncardiac surgery [J]. J Am Coll Cardiol, 2004, 44 (7): 1446-1453.
11	Romero L, de Virgilio C. Preoperative cardiac risk assessment: an updatedapproach [J]. Arch Surg, 2001, 136 (12): 1370-1376.
12	Cleland JG, Ghosh J, Freemantle N, et al. Clinical trials update and cumulative meta-analyses from the American College of Cardiology: WATCH, SCD-HeFT, DINAMIT, CASINO, INSPIRE, STRATUS-US, RIO-Lipids and cardiac resynchronisation therapy in heart failure [J]. Eur J Heart Fail, 2004, 6(4): 501-508.
13	Delaney A, Bradford C, Mccaffrey J, et al. Levosimendan for the treatment of acute severe heart failure: a meta-analysis of randomised controlled trials [J]. Int J Cardiol, 2010, 138(3): 281-289.
14	Toller W, Heringlake M, Guarracino F, et al. Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion [J]. Int J Cardiol, 2015, 184: 323-336.
15	Nieminen MS, Fruhwald S, Heunks LM, et al. Levosimendan: current data, clinical use and future development [J]. Heart Lung Vessel, 2013, 5(4): 227-245.
16	Elahi MM, Lam J, Asopa S, et al. Levosimendan versus an intra-aortic balloon pump in adult cardiac surgery patients with low cardiac output [J]. J Cardiothorac Vasc Anesth, 2011, 25(6): 1154-1162.
17	De Hert SG, Lorsomradee S, Cromheecke S, et al. The effects of levosimendan in cardiac surgery patients with poor left ventricular function [J]. Anesth Analg, 2007, 104 (4): 766-773.
18	Ponschab M, Hochmair N, Ghazwinian N, et al. Levosimendan infusion improves haemodynamics in elderly heart failure patients undergoing urgent hip fracture repair [J]. Eur J Anaesthesiol, 2008, 25(8): 627-633.
19	Merlo M, Pyxaras SA, Pinamonti B, et al. Prevalence and prognostic significance of left ventricular reverse remodeling in dilated cardiomyopathy receiving tailored medical treatment [J]. J Am Coll Cardiol, 2011, 57(13): 1468-1476.
20	Akao M, Ohler A, O’Rourke B, et al. Mitochondrial ATP-senstive potassium channels inhibit apoptosisinduced by oxidative stress in cardiac cell [J]. Circ Res, 2001, 88(12): 1267-1275.

组别	例数	性别（男/女，例）	年龄（岁，±s）	BMI（kg/m²，±s）	手术时间（min，±s）	LVEF（%，±s）	BNP（pg/ml，±s）	CI（L/min· m²，±s）	CO（L/min，±s）
左西孟旦组	32	15/17	75±4	24.3±2.4	95±11	45±5	1201±213	2.6±0.3	5.3±1.2
对照组	32	14/18	76±3	23.9±2.0	90±14	44±8	1189±286	2.7±0.5	5.2±1.4
统计值	?	χ²=0.036	t=0.419	t=0.279	t=0.739	t=0.358	t=0.086	t=0.525	t=0.137
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	性别（男/女，例）	年龄（岁，±s）	BMI（kg/m²，±s）	手术时间（min，±s）	LVEF（%，±s）	BNP（pg/ml，±s）	CI（L/min· m²，±s）	CO（L/min，±s）
左西孟旦组	32	15/17	75±4	24.3±2.4	95±11	45±5	1201±213	2.6±0.3	5.3±1.2
对照组	32	14/18	76±3	23.9±2.0	90±14	44±8	1189±286	2.7±0.5	5.2±1.4
统计值	?	χ²=0.036	t=0.419	t=0.279	t=0.739	t=0.358	t=0.086	t=0.525	t=0.137
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	LVEF（%）		BNP（pg/ml）		CI（L/min· m²）		CO（L/min）
组别	例数	术后24 h	术后7 d	术后24 h	术后7 d	术后24 h	术后7 d	术后24 h	术后7 d
左西孟旦组	32	48±6	50±4	1432±164	1024±199	3.4±0.5	3.5±0.4	7.5±1.6	7.4±1.3
对照组	32	39±6	42±6	1734±207	1345±183	2.4±0.4	2.6±0.3	5.0±1.3	5.3±1.7
t值	?	2.428	3.150	2.989	2.693	3.349	3.777	2.615	2.620
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

组别	例数	LVEF（%）		BNP（pg/ml）		CI（L/min· m²）		CO（L/min）
组别	例数	术后24 h	术后7 d	术后24 h	术后7 d	术后24 h	术后7 d	术后24 h	术后7 d
左西孟旦组	32	48±6	50±4	1432±164	1024±199	3.4±0.5	3.5±0.4	7.5±1.6	7.4±1.3
对照组	32	39±6	42±6	1734±207	1345±183	2.4±0.4	2.6±0.3	5.0±1.3	5.3±1.7
t值	?	2.428	3.150	2.989	2.693	3.349	3.777	2.615	2.620
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

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