Although inotropes have a favorable effect on central hemodynamics in patients with heart failure, their effect on renal hemodynamics is incompletely defined. The purpose of this study is to evaluate the efficacy of a 75 min intravenous infusion of levosimendan compared to a 75 min infusion of dobutamine on renal hemodynamics and function in patients with chronic heart failure and signs of cardiorenal syndrome. The investigators hypothesis is that patients treated with levosimendan will show greater increases in renal blood flow and glomerular filtration rate (GFR) than those treated with dobutamine.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
33
Sahlgrenska University Hospital
Gothenburg, Sweden
Change in renal blood flow
Para-aminohippuric acid (PAH) infusion clearance
Time frame: 75 min minus baseline
Change in glomerular filtration rate
Chrome-ethylenediaminetetraacetic acid (EDTA) infusion clearance
Time frame: 75 min minus baseline
Change in renal vascular resistance
Renal blood flow divided by the difference between renal arterial pressure and renal venous pressure
Time frame: 75 min minus baseline
Change in central hemodynamics
Right atrial pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, mean arterial pressure, cardiac output, pulmonary vascular resistance and systemic vascular resistance measured with a pulmonary artery thermodilution catheter.
Time frame: 75 min minus baseline
Change in renal oxygen consumption and oxygen extraction
Oxygen consumption: Renal blood flow multiplied by arterial-renal venous oxygen difference. Oxygen extraction: Ratio of renal oxygen consumption to renal oxygen delivery
Time frame: 75 min minus baseline
Change in filtration fraction
Ratio of glomerular filtration rate to renal plasma flow
Time frame: 75 min minus baseline
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