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«Клиническая физиология кровообращения»

Главный редактор

Лео Антонович Бокерия, доктор медицинских наук, профессор, академик РАН и РАМН, директор ФГБУ «НМИЦССХ им. А.Н. Бакулева» МЗ РФ

Влияние левосимендана на почечную функцию у пациентов с острой сердечной недостаточностью

Авторы: Рахимов А.З., Рустамов Б.Е., Пирцхалава С.Д., Асымбекова Э.У.

Организация:
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» (президент – академик РАН и РАМН Л.А. Бокерия) Минздрава России, Рублевское ш., 135, Москва, 121552, Российская Федерация

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Раздел: Обзоры

DOI: https://doi.org/10.24022/1814-6910-2021-18-1-37-45

УДК: 616.61-008.64:616.12-008.46]:615.2

Библиографическая ссылка: Клиническая физиология кровообращения. 2021; 1 (18): 37-45

Цитировать как: Рахимов А.З., Рустамов Б.Е., Пирцхалава С.Д., Асымбекова Э.У. . Влияние левосимендана на почечную функцию у пациентов с острой сердечной недостаточностью. Клиническая физиология кровообращения. 2021; 1 (18): 37-45. DOI: 10.24022/1814-6910-2021-18-1-37-45

Ключевые слова: левосимендан, острая сердечная недостаточность, дисфункция почек, кардиоренальный синдром, синдром низкого сердечного выброса

Поступила / Принята к печати:  18.06.2020 / 27.07.2020

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Аннотация

Негликозидные инотропные препараты могут быть использованы для краткосрочного лечения острой сердечной недостаточности с почечной дисфункцией (кардиоренальный синдром), особенно у пациентов с низким сердечным выбросом, чтобы избежать почечной гипоперфузии. Левосимендан представляется многообещающим вариантом для улучшения почечной перфузии и коррекции почечной дисфункции у пациентов с острой сердечной недостаточностью. Несмотря на во многом нейтральные результаты последних рандомизированных исследований, на сегодняшний день представляется очевидным, что левосимендан уместно применять в кардиологии и кардиохирургии у больных с острой сердечной недостаточностью с низким сердечным выбросом и рефрактерностью к диуретикам, особенно при наличии почечной дисфункции. Его использование может помочь преодолеть самый тяжелый и опасный период в течении этого заболевания.

Литература

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****
  1. Papp Z., Edes I., Fruhwald S., De Hert S.G., Salmenpera M., Leppikangas H. et al. Levosimendan: molecular mechanisms and clinical implications: consensus of experts on the mechanisms of action of levosimendan. Int. J. Cardiol. 2012; 159: 82–7. DOI: 10.1016/j.ijcard.2011.07.022
  2. Pollesello P., Papp Z., Papp J.G. Calcium sensitizers: what have we learned over the last 25 years? Int. J. Cardiol. 2016; 203: 543–8. DOI: 10.1016/j.ijcard. 2015.10.240
  3. Brixius K., Reicke S., Schwinger R.H. Beneficial effects of the Ca(2+) sensitizer levosimendan in human myocardium. Am. J. Physiol. Heart Circ. Physiol. 2002; 282 (1): H131–7. DOI: 10.1152/ajpheart.2002. 282.1.H131
  4. Ukkonen H., Saraste M., Akkila J., Knuuti M.J., Lehikoinen P., Na° gren K. et al. Myocardial efficiency during calcium sensitization with levosimendan: a noninvasive study with positron emission tomography and echocardiography in healthy volunteers. Clin. Pharmacol. Ther. 1997; 61: 596–607. DOI: 10.1016/S0009-9236(97)90139-9
  5. Nieminen M.S., Pollesello P., Vajda G., Papp Z. Effects of levosimendan on the energy balance: preclinical and clinical evidence. J. Cardiovasc. Pharmacol. 2009; 53 (4): 302–10. DOI: 10.1097/FJC.0b013e31819c9a17
  6. Louhelainen M., Vahtola E., Kaheinen P., Leskinen H., Merasto S., Kytö V. et al. Effects of levosimendan on cardiac remodeling and cardiomyocyte apoptosis in hypertensive Dahl/Rapp rats. Br. J. Pharmacol. 2007; 150 (7): 851–61. DOI: 10.1038/sj.bjp.0707157
  7. Nieminen M.S., Fruhwald S., Heunks L.M., Suominen P.K., Gordon A.C., Kivikko M., Pollesello P. Levosimendan: current data, clinical use and future development. Heart Lung Vessels. 2013; 5 (4): 227–45.
  8. Mebazaa A., Nieminen M.S., Packer M., CohenSolal A., Kleber F.X., Pocock S.J. et al. SURVIVE Investigators Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. JAMA. 2007; 297 (17): 1883–91. DOI: 10.1001/jama.297.17.1883
  9. Packer M., Colucci W., Fisher L., Massie B.M., Teerlink J.R., Young J. et al. Effect of levosimendan on the short-term clinical course of patients with acutely decompensated heart failure. JCHF. 2013; 1: 103–11.
  10. Salzman H.E., Sharma K., Mather P.J., Rubin S., Adams S., Whellan D.J. Renal dysfunction in heart failure patients: what is the evidence? Heart Fail. Rev. 2007; 12: 37–47. DOI: 10.1007/s10741-007-9006-5
  11. Mahon N.G., Blackstone E.H., Francis G.S., Starling R.C. 3rd, Young J.B., Lauer M.S. The prognostic value of estimated creatinine clearance alongside functional capacity in ambulatory patients with chronic congestive heart failure. J. Am. Coll. Cardiol. 2002; 40 (6): 1106–13. DOI: 10.1016/S0735-1097(02)02125-3
  12. Ronco C., Haapio M., House A.A., Anavekar N., Bellomo R. Cardiorenal syndrome. J. Am. Coll. Cardiol. 2008; 52: 1527–39. DOI: 10.1016/j.jacc.2008.07.051
  13. Yilmaz M.B., Grossini E., Silva Cardoso J.C., Édes I., Fedele F., Pollesello P. et al. Renal effects of levosimendan: a consensus report. Cardiovasc. Drugs. Ther. 2013; 27 (6): 581–90. DOI: 10.1007/s10557-013-6485-6
  14. Pagel P.S., Hettrick D.A., Warltier D.C. Influence of levosimendan, pimobendan, and milrinone on the regional distribution of cardiac output in anaesthetized dogs. Br. J. Pharmacol. 1996; 119 (3): 609–15. DOI: 10.1111/j.1476-5381.1996.tb15716.x
  15. Zager R.A., Johnson A.C., Lund S., Hanson S.Y., Abrass C.K. Levosimendan protects against experimental endotoxemic acute renal failure. Am. J. Physiol. Renal. Physiol. 2006; 290 (6): F1453–62. DOI: 10.1152/ajprenal.00485.2005
  16. Rehberg S., Ertmer C., Vincent J.L., Spiegel H.U., Köhler G., Erren M. et al. Effects of combined arginine vasopressin and levosimendan on organ function in ovine septic shock. Crit. Care Med. 2010; 38 (10): 2016–23. DOI: 10.1097/CCM.0b013e3181ef4694
  17. Grossini E., Molinari C., Pollesello P., Bellomo G., Valente G., Mary D. et al. Levosimendan protection against kidney ischemia/reperfusion injuries in anesthetized pigs. J. Pharmacol. Exp. Ther. 2012; 342 (2): 376–88. DOI: 10.1124/jpet.112.193961
  18. Yakut N., Yasa H., Bahriye Lafci B., Ortac R., Tulukoglu E., Aksun M. et al. The influence of levosimendan and iloprost on renal ischemia-reperfusion: an experimental study. Interact. Cardiovasc. Thorac. Surg. 2008; 7: 235–9. DOI: 10.1510/icvts.2007.161356
  19. Gecit I., Kavak S., Yüksel M.B., Basel H., Bektas H., Gümrükc,üoglu H.A. et al. Effect of short-term treatment with levosimendan on oxidative stress in renal tissues of rats. Toxicol. Ind. Health. 2014; 30: 47–51. DOI: 10.1177/0748233712451773
  20. Bragadottir G., Redfors B., Ricksten S.E. Effects of levosimendan on glomerular filtration rate, renal blood flow, and renal oxygenation after cardiac surgery with cardiopulmonary bypass: a randomized placebo-controlled study. Crit. Care Med. 2013; 41 (10): 2328–35. DOI: 10.1097/CCM.0b013e31828e946a
  21. Fedele F., Bruno N., Brasolin B., Caira C., D'Ambrosi A., Mancone M. Levosimendan improves renal function in acute decompensated heart failure: possible underlying mechanisms. Eur. J. Heart Fail. 2014; 16 (3): 281–8. DOI: 10.1002/ejhf.9
  22. Follath F., Cleland J.G., Just H., Papp J.G., Scholz H., Peuhkurinen K. et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet. 2002; 360: 196–202. DOI: 10.1016/S0140-6736(02)09455-2
  23. Lannemyr L., Ricksten S.-E., Rundqvist B., Andersson B., Bartfay S.-E., Ljungman C. et al. Differential effects of levosimendan and dobutamine on glomerular filtration rate in patients with heart failure and renal impairment: a randomized double-blind controlled trial. J. Am. Heart Assoc. 2018; 7: e008455. DOI: 10.1161/JAHA.117.008455
  24. Sanfilippo F., Knight J.B., Scolletta S., Santonocito C., Pastore F., Lorini F.L. et al. Levosimendan for patients with severely reduced left ventricular systolic function and/or low cardiac output syndrome undergoing cardiac surgery: a systematic review and meta-analysis. Crit. Care. 2017; 21 (1): 252. DOI: 10.1186/s13054-017-1849-0
  25. Putzu A., Clivio S., Belletti A., Cassina T. Perioperative levosimendan in cardiac surgery: a systematic review with meta-analysis and trial sequential analysis. Int. J. Cardiol. 2018; 251: 22–31. DOI: 10.1016/j.ijcard.2017.10.077
  26. Niu Z.Z., Wu S.M., Sun W.Y., Hou W.M., Chi Y.F. Perioperative levosimendan therapy is associated with a lower incidence of acute kidney injury after cardiac surgery: a meta-analysis. J. Cardiovasc. Pharmacol. 2014; 63 (2): 107–12. DOI: 10.1097/FJC.0000000000000028
  27. Bove T., Matteazzi A., Belletti A., Paternoster G., Saleh O., Taddeo D. et al. Beneficial impact of levosimendan in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials. Heart Lung. Vessel. 2015; 7 (1): 35–46.
  28. Yilmaz M.B., Yalta K., Yontar C., Karadas F., Erdem A., Turgut O.O. et al. Levosimendan improves renal function in patients with acute decompensated heart failure: comparison with dobutamine. Cardiovasc. Drugs Ther. 2007; 21: 431–5. DOI: 10.1007/s10557-007-6066-7
  29. Hou Z.Q., Sun Z.X., Su C.Y., Tan H., Zhong X., Hu B. et al. Effect of levosimendan on estimated glomerular filtration rate in hospitalized patients with decompensated heart failure and renal dysfunction. Cardiovasc. Ther. 2013; 31: 108–14. DOI: 10.1111/1755-5922.12001
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Об авторах

  • Рахимов Акмал Закрияевич, канд. мед. наук, науч. сотр.; ORCID
  • Рустамов Бахт Ерашимович, канд. мед. наук, науч. сотр.; ORCID
  • Пирцхалава Софиа Давидовна, канд. мед. наук, врач-кардиолог; ORCID
  • Асымбекова Эльмира Уметовна, доктор мед. наук, вед. науч. сотр.; ORCID

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