Efficacy and safety of intermittent, long-term, concomitant dobutamine and levosimendan infusions in severe heart failure refractory to dobutamine alone

Nanas, John N.; Papazoglou, P.; Tsagalou, Eleftheria P.; Ntalianis, Argirios; Tsolakis, Elias; Terrovitis, John; Kanakakis, John; Nanas, Seraphim; Alexopoulos, George P.; Anastasiou-Nana, Maria

doi:10.1016/j.amjcard.2004.11.033

Cited by 62 publications

(47 citation statements)

References 15 publications

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“…12,13 Nanas et al reported that intermittent, long-term, concomitant dobutamine and levosimendan infusions in severe heart failure refractory to dobutamine alone resulted in improved clinical and haemodynamic status, and confirmed a significantly increased 45-day survival. 12 Recently, Parissis et al demonstrated that serial levosimendan infusions alone led to sustained improvement in left ventricular performance. 13 This is only the second reported study into the use of repeated levosimendan infusions alone to treat decompensated heart failure.…”

Section: Of Levosimendan Improves Haemodynamics and Symptoms In Thesementioning

confidence: 98%

“…11 Few studies have explored the efficacy and safety of intermittent repeated doses of levosimendan and to our knowledge there have been no reports of levosimendan being given in the out-patient setting. 12,13 In this prospective observational study we describe our single-centre experience of administering repeated doses of levosimendan to patients with decompensated heart failure.…”

Section: Introductionmentioning

confidence: 99%

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Repeated Infusions of Levosimendan: Well Tolerated and Improves Functional Capacity in Decompensated Heart Failure – A Single-Centre Experience

Parle

Thomas²,

Dembo³

et al. 2008

Heart, Lung and Circulation

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Section: Of Levosimendan Improves Haemodynamics and Symptoms In Thesementioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Repeated Infusions of Levosimendan: Well Tolerated and Improves Functional Capacity in Decompensated Heart Failure – A Single-Centre Experience

Parle

Thomas²,

Dembo³

et al. 2008

Heart, Lung and Circulation

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“…In einer weiteren klinischen Studie erhielten Patienten mit fortgeschrittener Herzinsuffizienz, die refraktär gegenüber Dobutamin war, entweder zusätzlich Dobutamin oder Levosimendan. In der Levosimendan-Gruppe kam es zu einer verbesserten 45-Tage-Überlebensrate von 61 vs. 6% in der Dobutamin-Gruppe [53].…”

Section: Kombination Mit Weiteren Therapeutika Der Herzinsuffizienzunclassified

Role of Levosimendan in intensive care treatment of myocardial insufficiency

Rehberg¹,

Ertmer²,

Aken³

et al. 2007

Anaesthesist

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Levosimendan is a calcium sensitizer that is currently in the focus of intensive care medicine because it may be superior to standard inotropic agents in the treatment of acute myocardial insufficiency. The effects of levosimendan mainly depend on three predominant mechanisms: 1) positive inotropic effect by increasing the sensitivity of cardiac myofilaments to calcium ions, 2) vasodilatory effect by stimulation of adenosine triphosphate-sensitive potassium channels and 3) inhibition of phosphodiesterase-III. In a large number of experimental and clinical studies further possible indications for levosimendan have been described, e.g. cardioprotection during ischemia, cardiogenic shock, septic myocardial insufficiency and pulmonary hypertension. This review article critically summarizes the current scientific and clinical knowledge about levosimendan, its pharmacologic characteristics, mechanisms of action as well as indications and potential risks.

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“…Levosimendan metabolised to the active metabolite OR-1896 has a long half-live ( ϳ 1 week) [2] . Consequently, 2 patients were given additional courses of levosimendan, as benefits have been reported in patients receiving repetitive doses once this residual effect wears off [38] .…”

Section: Discussionmentioning

confidence: 99%

Acute Effects of Levosimendan on Cerebral and Systemic Perfusion and Oxygenation in Newborns: An Observational Study

Bravo

Lopez²,

Cabañas³

et al. 2010

Neonatology

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Background: Cardiovascular drugs play a major role in the pre- and postoperative care in neonates with congenital heart disease. Management strategies aim to optimise contractility, improve diastolic function, maintain adequate preload, and reduce afterload. Levosimendan, a novel inodilator agent, enhances myocardial contractility and causes peripheral and coronary vasodilation. Objectives: A systematic approach was used to evaluate the acute haemodynamic effects of levosimendan in critically ill infants with low cardiac output syndrome (LCOS). Methods: Infants received a continuous infusion of levosimendan, at a dose increased stepwise (range 0.1–0.2 µg/kg/min), during 48 h. Two near-infrared units were used to assess cerebral (frontal-parietal, c) and peripheral (thigh, p) perfusion and oxygenation. The changes in cerebral blood volume (ΔCBV), cerebral (cΔHbD) and peripheral (pΔHbD) intravascular oxygenation and the cerebral (cTOI) and peripheral (pTOI) tissue oxygenation index that followed levosimendan administration were continuously monitored. Blood pressure, heart rate, and temperature were continuously recorded. In addition, baseline and end-of-study pH, blood gases, lactate and haematocrit were determined. Results: Seven doses of levosimendan were investigated. The mean study time was 13.3 (7–19) h. Levosimendan produced an increase in cΔHbD (p < 0.05) and pΔHbD (NS) and a decrease in heart rate (p < 0.001) and lactate (p < 0.05). Trends showed an increase in mean blood pressure (NS). These results were independent of the effect of time. Mixed linear model analysis identified blood pressure changes and levosimendan as factors independently associated with cΔHbD. Conclusions: Levosimendan improves cerebral and systemic perfusion and oxygenation in critically ill infants suffering from LCOS.

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Efficacy and safety of intermittent, long-term, concomitant dobutamine and levosimendan infusions in severe heart failure refractory to dobutamine alone

Cited by 62 publications

References 15 publications

Repeated Infusions of Levosimendan: Well Tolerated and Improves Functional Capacity in Decompensated Heart Failure – A Single-Centre Experience

Repeated Infusions of Levosimendan: Well Tolerated and Improves Functional Capacity in Decompensated Heart Failure – A Single-Centre Experience

Role of Levosimendan in intensive care treatment of myocardial insufficiency

Acute Effects of Levosimendan on Cerebral and Systemic Perfusion and Oxygenation in Newborns: An Observational Study

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