Effect of positive inotrope therapy on serum adiponectin levels in acute decompensated chronic heart failure

The aim of this study was to compare the effects of dobutamine and levosimendan on adiponectin, NT-proBNP, functional capacity and echocardiographic parameters in patients with acute decompensated chronic heart failure. The present study included 44 consecutive patients hospitalized with acutely decompensated chronic heart failure (NYHA Class IV), requiring inotropic therapy. Patients were randomized to either levosimendan or dobutamine for intravenous inotropic support, the 22 number of over 44 patients were given levosimendan therapy and others were given dobutamine therapy. Before and 3 days after treatment, serum levels adiponectin, NT-proBNP and routine blood parameters and echocardiographic parameters were obtained. There was no difference for pre-treatment baseline charestics between levosimendan and dobutamine groups (p>0,05). The serum adiponectin levels positively correlated with the log-transformed values of the plasma NT-proBNP (r=0.53, p<0,0001) and inversely correlated with the body mass index ( r= - 0.66, p<0,0001). There were significant increase LVEF at the levosimendan group in post-treatment 3 days. However, there was not change LVEF in the Dobutamine group (p>0,05). There were significant reductions in post-treatment 3 days serum NT-proBNP level, pulmonary artery systolic pressure and singnificant improvement in functional capacity in levosimendan and dobutamine groups. However the improvement in these parameters in levosimendan group is greater than the dobutamine but this difference not have statistically meaninig. After treatment it is seen that adiponectin levels in levosimendan and dobutamine groups were significant reductions but reductions in levosimendan group were significantly greater than the dobutamine group.The effect of levosimendan therapy on adiponectin level reduction is greater than the dobutamine group and LVEF improvement is again better with the levosimendan therapy on patients of acute decompensated chronic heart failure, who needs positive inotropic support therapy.In addition, after treatment it is seen that improvoment in plasma BNP level, pulmonary artery systolic pressure, functional capacity is better with the levosimendan therapy, however this difference does not have statistically meaning.