The effect of levosimendan on Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio and QRS interval in heart failure patients

Authors : Ibrahim Aktas, Alper Karakus, Sencer Camci, Hasan Ari, Selma Ari, Ahmet Tutuncu, Mehmet MELEK, Tahsin BOZAT

Pages : 220-226

Doi:10.18621/eurj.278899

View : 24 | Download : 8

Publication Date : 2017-11-04

Article Type : Research Paper

Abstract :Increased Tp-e interval insert ignore into journalissuearticles values(from the peak-to-the-end of the electrocardiographic T wave); and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. We aimed to evaluate the acute effects of levosimendan on Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio and QRS interval in patients with severe heart failure. Methods. The study included 85 patients with decompansed heart failure, who were treated with levosimendan in our cardiology department. We evaluated the patients retrospectively. QT and Tp-e interval were assessed in the precordial leads. QRS duration was determined in the single lead which had the longest QRS. Electrocardiographic measurements was performed the basal insert ignore into journalissuearticles values(just before the levosimendan); and 24 th hour after the levosimendan infusion insert ignore into journalissuearticles values(just after the levosimendan infusion);. Results. No significant differences were found between before and after treatment of levosimendan with respect to Tp-e and QTc interval, QRS duration, Tp-e/QT and Tp-e/QTc ratio insert ignore into journalissuearticles values(pretreatment versus 24 th hour values; p >0.05);. Subgroup analysis was performed in the patients with inotropic therapy including dopamine and/or dobutamin insert ignore into journalissuearticles values(34 patients); and without inotropic therapy insert ignore into journalissuearticles values(49 patients); during the levosimendan infusion. The analysis showed that pretreatment and 24 th hour values of Tp-e interval and Tp-e/QT ratio were significantly higher in the inotropic therapy group; insert ignore into journalissuearticles values(Pretreatment; Tp-e: 100.12±22.96 milliseconds [ms] versus 89.59±17.67 ms; p =0.03, Tp-e/QT: 0.26±0.05 versus 0.23±0.04; p =0.007, 24 th hour: Tp-e: 101.41±27.09 ms versus 88.77±15.89 ms; p =0.009, Tp-e/QT: 0.26±0.07 versus 0.23±0.05; p =0.03);. However intra-group changes of these parameters, before and after levosimendan treatment, were not significant insert ignore into journalissuearticles values( p >0.05);. Conclusion. Our results suggested that, therapeutic doses of levosimendan infusion don’t have a significant effect on Tp-e and Tp-e/QT parameters. However inotropic therapy significantly increases these parameters. 
Keywords : Levosimendan, arrhythmia, Tp e interval, QT interval, heart failure