Impact Of Using LevosemidanVersus DobutamineOn Right Ventricular Function In AdultPatients Undergoing Elective Valve Replacement Surgery (rt side failur)

February 15, 2026 updated by: Abdelkader Abdelrahman Abdelkader Elbakry, Helwan University

in this prospective, randomized, controlled double blinded study conducted at Helwan University Hospitals include 52 patients with rheumatic mitral and/or aortic valve disease and pulmonary arterial hypertension at the start of rewarming, patients will be randomly assigned into either group 1 (levosimendan) or group 2 (dobutamine ) Group 1 patients will receive dobutamine, 3-5 microgram/kg group 2 patients will receive levosimendan 6 ug/kg bolus over 10 minutes, followed by infusion at a rate of 0.1 mg/kg/min Transthoracic echocardiography performed before induction of anaesthesia (baseline), 6 and 12 hours post surgery . In addition, transthoracic echocardiography also performed 24 hours post extubating. Transoesophageal echocardiography (TEE) examination performed during the intraoperative period before the initiation of CPB (pre CPB) and 30 minutes after separation from CPB (post-CPB) Echocardiographic parameters measured will include tricuspid annular plane systolic excursion (TAPSE), Tei index and myocardial systolic velocities at the tricuspid annulus (S/) for the assessment of right ventricular systolic function, and ratio of tricuspid inflow to tricuspid annular diastolic velocity (E/E/) for the assessment of right ventricular diastolic function.

Pulmonary artery pressure will be assessed frequently by transthoracic echo during every assessment.

Study Overview

Status

Completed

Conditions

Study Type

Observational

Enrollment (Actual)

52

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Giza, Egypt, 12566
        • Helwan University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Adult patients scheduled for valve replacement surgery with PAH (an estimated right ventricular systolic pressure more than 50 mmHg, or mean PAP more than 40 mmHg, or systolic PAP exceeding 50% of systemic systolic pressure). Pregnant Patients or .

Patients with severe renal dysfunction (GFR 15 to 29 ml/min per 1.73 m2 )or Severe hepatic or patients with Uncontrolled diabetes mellitus (HBA1C more than 8 )or patients needed inotropic support before surgery were excluded from the study.

Description

Inclusion Criteria:

  • Age ≥18 years
  • Undergoing mitral and/or aortic valve replacement
  • PAH (an estimated right ventricular systolic pressure more than 50 mmHg, or mean PAP more than 40 mmHg, or systolic PAP exceeding 50% of systemic systolic pressure).

Exclusion Criteria:

  • Potential pregnancy.
  • Refusal to participate.
  • Patients with severe renal dysfunction (GFR 15 to 29 ml/min per 1.73 m2 )
  • Severe hepatic dysfunction.( Grade 4: AST/ALT >20.0 x(upper limit normal )
  • Prolonged QT interval.
  • Emergency surgery,
  • Requiring preoperative inotropes.
  • Uncontrolled diabetes mellitus (HBA1C more than 8 )

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
group 1(levosimendan)
group 1 (levosimendan) Group 1 will receive levosimendan 6 ug/kg bolus over 10 minutes, followed by infusion at a rate of 0.1 mg/kg/min
Group 2 (dobutamine)
r group 2 (dobutamine ) Group 2 patients will receive dobutamine, 3-5 microgram/kg group

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
post operative change of right ventricular function during 1 week after surgery mesured by ECHO parameters
Time Frame: from enrollment to the end of treatment at 1 week
echocardiographic parameters include ,TAPSE( tricused annular plane excursion in cm) , Tei index, myocardial systolic velocities at the tricuspid annulus S/in cm/s , ratio of tricuspid inflow to tricuspid annular diastolic velocity (E/e/) those parameters will be combined for the assessment of right ventricular function.
from enrollment to the end of treatment at 1 week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 1, 2024

Primary Completion (Actual)

August 1, 2025

Study Completion (Actual)

August 1, 2025

Study Registration Dates

First Submitted

January 23, 2026

First Submitted That Met QC Criteria

February 15, 2026

First Posted (Actual)

February 18, 2026

Study Record Updates

Last Update Posted (Actual)

February 18, 2026

Last Update Submitted That Met QC Criteria

February 15, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • IORG registry num: IORG0011670
  • REC faculty of medicine helwan (Registry Identifier: IORG0011670)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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