Levosimendan Efficacy and Safety: 20 Years of SIMDAX in Clinical Use

Papp, Zoltán; Agostoni, Piergiuseppe; Álvarez, Julián; Béttex, Dominique; Bouchez, Stefan; Brito, Dulce; Černý, V.; Comín‐Colet, Josep; Crespo-Leiro, María G.; Delgado, Juan; Édes, István; Еременко, А А; Farmakis, Dimitrios; Fedele, Francesco; Fonseca, Cândida; Fruhwald, Sonja; Girardis, Massimo; Guarracino, Fabio; Harjola, Veli‐Pekka; Heringlake, Matthias; Herpain, Antoine; Heunks, Leo; Husebye, Trygve; Ivančan, Višnja; Karason, Kristjan; Kaul, Sundeep; Kivikko, Matti; Kubica, Jacek; Masip, Josep; Matskeplishvili, Simon; Mebazaa, Alexandre; Nieminen, Markku S.; Oliva, Fabrizio; Jg, Papp; Parissis, John; Parkhomenko, Alexander; Põder, Pentti; Pölzl, Gerhard; Reinecke, Alexander; Ricksten, Sven‐Erik; Říha, Hynek; Rudiger, Alain; Sarapohja, Toni; Schwinger, Robert H. G.; Toller, Wolfgang; Tritapepe, Luigi; Tschöpe, Carsten; Wikström, Gerhard; Lewinski, Dirk von; Vrtovec, Bojan; Pollesello, Piero

doi:10.1097/fjc.0000000000000859

Cited by 55 publications

(11 citation statements)

References 212 publications

(201 reference statements)

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“…This singularity has contributed to levosimendan establishing itself as a prominent addition to the medical armamentarium, aided among other things by the greatly expanded use of beta-blockers in the management of HF: the availability of a calcium-sensitizing inotrope that works by energy-neutral mechanisms not dependent on adrenergic pathways is a tangible advantage and a quality that differentiates levosimendan from conventional inotropes such as dobutamine [88,89]. Similarly, the ability to administer levosimendan in an outpatient setting and its persistence of effect due to the formation of a long-acting active metabolite has stimulated new interest in the feasibility of ambulatory medical management for patients in the more advanced stages of HF, encouraging hopes that frequency of hospital admission may be reduced for these patients and health-related quality of life preserved.…”

Section: Discussionmentioning

confidence: 99%

The inodilator levosimendan: 20 years of experience in various settings of cardiac care

Tritapepe¹,

Pollesello

Grossini³

2020

Medical Research Journal

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Levosimendan emerged in the 1990s as a first-in-class inotrope and vasodilator that enhances cardiac contractility by sensitizing the contractile response to cardiac troponin C and causes vasodilatation by opening potassium-dependent ATP channels on vascular smooth muscle cells. Since its clinical debut in 2000, it has established itself as a valuable resource in the management of acute decompensated heart failure and is one of very few successful medical innovations of its kind in that field in recent decades. Its pharmacology is notable for delivering inotropy without an increase in myocardial oxygen consumption and for an array of secondary ('pleiotropic') effects that include an anti-ischemic effect, pre-conditioning and post-conditioning and cardioprotective effects and anti-oxidative effects. Proceeding from those properties it has been proposed that in addition to its use in various scenarios of low cardiac output levosimendan may be beneficial in other conditions associated with acutely decompensated heart failure, including right ventricular failure, subarachnoid hemorrhage, and cardiogenic shock with multi-organ dysfunction. The potential of levosimendan for kidney protection in situations of the cardio-renal syndrome has been identified. Additional lines of investigation include the use of levosimendan for perioperative hemodynamic support, its administration as repeated intermittent infusions to sustain patients with advanced heart failure and its application in a range of critical care settings. Levosimendan has also provided a template and a starting point for the development of a new generation of cardio-active drugs and is currently being evaluated in advanced clinical trials for the management of pulmonary hypertension in patients with heart failure with preserved ejection fraction.

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Section: Discussionmentioning

confidence: 99%

The inodilator levosimendan: 20 years of experience in various settings of cardiac care

Tritapepe¹,

Pollesello

Grossini³

2020

Medical Research Journal

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“…Levosimendan is a calcium sensitizer 85 that can increase cardiac inotropy through a direct effect on cardiac troponin C. Therefore, it has the advantage of not increasing cAMP or Ca 2+ itself, both of which are the basis of the negative results with catecholamine use, and its function is not impaired by pre-treatment with β-blockers. 22,86 In addition to its main action, levosimendan averages the opening of ATP-dependent K + channels in vascular smooth muscle cells by inducing an increase in blood perfusion and systemic vasodilatation. 86 Similarly, it opens ATP-dependent K + channels on the mitochondrial inner membrane resulting in cardioprotection, reduction of infarct size, and mitigation of ischaemia/reperfusion lesions.…”

Section: Levosimendanmentioning

confidence: 99%

Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

Riccardi,

Pagnesi,

Chioncel

et al. 2024

European J of Heart Fail

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Cardiogenic shock is a primary cardiac disorder that results in both clinical and biochemical evidence of tissue hypoperfusion and can lead to multi‐organ failure and death depending on its severity. Inadequate cardiac contractility or cardiac power secondary to acute myocardial infarction remains the most frequent cause of cardiogenic shock, although its contribution has declined over the past two decades, compared with other causes. Despite some advances in cardiogenic shock management, this clinical syndrome is still burdened by an extremely high mortality. Its management is based on immediate stabilization of haemodynamic parameters so that further treatment, including mechanical circulatory support and transfer to specialized tertiary care centres, can be accomplished. With these aims, medical therapy, consisting mainly of inotropic drugs and vasopressors, still has a major role. The purpose of this article is to review current evidence on the use of these medications in patients with cardiogenic shock and discuss specific clinical settings with indications to their use.

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“…Standard evidence-based therapies for the treatment of HF include inotropic agents, vasodilators and loop diuretics along with angiotensin-converting-enzyme inhibitors and beta-blockers (Machaj et al, 2019 p. 147). Levosimendan, a calcium sensitizer, has been used extensively for the treatment of a variety of cardiac pathologies in many countries for two decades, although it currently in active clinical evaluation in the United States (Papp et al, 2020). A 2019 meta-analysis by Heng Li and co-authors assessing clinical outcomes of pharmacological interventions included 32 studies and found levosimendan was more effective in reducing ventricular wall tension and improving systolic function in patients with HFrEF as compared with other drugs including tolvaptan and ivabradine.…”

Section: Hameed Murtaza 3 Rd Year Student Of Medicine Kiev Medical University Ukrainementioning

confidence: 99%

Novel Agents for the Treatment of Heart Failure

Parchami¹,

Hameed²

2021

grail-of-science

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Levosimendan Efficacy and Safety: 20 Years of SIMDAX in Clinical Use

Cited by 55 publications

References 212 publications

The inodilator levosimendan: 20 years of experience in various settings of cardiac care

The inodilator levosimendan: 20 years of experience in various settings of cardiac care

Medical therapy of cardiogenic shock: Contemporary use of inotropes and vasopressors

Novel Agents for the Treatment of Heart Failure

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