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

Year 2017, Volume: 3 Issue: 3, 220 - 226, 04.11.2017

Ibrahim Aktas Alper Karakus , Sencer Camci , Hasan Ari , Selma Ari , Ahmet Tutuncu Mehmet Melek , Tahsin Bozat

https://doi.org/10.18621/eurj.278899

Cited By: 1

Abstract

Increased Tp-e interval (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 (just before the levosimendan) and 24th
hour after the levosimendan infusion (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 (pretreatment versus 24th hour values; p>0.05). Subgroup analysis was performed
in the patients with inotropic therapy including dopamine and/or dobutamin (34
patients) and without inotropic therapy (49 patients) during the levosimendan
infusion. The analysis showed that pretreatment and 24th hour values
of Tp-e interval and Tp-e/QT ratio were significantly higher in the inotropic
therapy group; (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, 24th
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 (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

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