Levosimendan in the modern treatment of patients with acute heart failure of various aetiologies

Glinka, Lidia; Mayzner-Zawadzka, Ewa; Onichimowski, Dariusz; Jalali, Rakesh; Glinka, M

doi:10.5114/aoms.2018.77055

Cited by 4 publications

(4 citation statements)

References 46 publications

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“…The advantage of levosimendan over other inotropes (eg dobutamine) is that it does not cause an increase in myocardial oxygen consumption. [ 10 ] It does not cause tachyphylaxis. It sensitizes the myocardium to calcium, without actually increasing the calcium influx.…”

Section: Discussionmentioning

confidence: 99%

Role of inhaled levosimendan in peripartum cardiomyopathy

Kundra

Kaur

2022

Saudi J Anaesth

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Levosimendan is an inodilator agent, which was initially widely used in low contractility states. However, its use has been restricted because of the invariable need to use a vasoconstrictor like norepinephrine, since it causes a marked fall in systemic vascular resistance (SVR). Hence its beneficial effects on the heart are compromised by the excessive fall in SVR. The inhalational route provides a better opportunity to exploit the positive cardiac effects, with a minimal effect on SVR. In this case report, we present a postpartum patient presenting with heart failure, in which inhalational levosimendan improved the hemodynamics and cardiac function, which was associated with relief of symptoms, with no need for other inotropes. As per our knowledge and extensive literature search, this is the first documented use of inhaled levosimendan in peripartum cardiomyopathy.

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Section: Discussionmentioning

confidence: 99%

Role of inhaled levosimendan in peripartum cardiomyopathy

Kundra

Kaur

2022

Saudi J Anaesth

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“…In the rat model, levosimendan used on its own in the treatment of verapamil poisoning increased hypotension and accelerated death in animals, compared to the control group [46]. Nevertheless, it may prove to be beneficial when other treatment options are not effective or when cardiovascular shock is refractory to standard therapies; it can be used in addition to other drugs in the treatment of cardiovascular shock [47,48].…”

Section: Discussionmentioning

confidence: 99%

Importance of early intervention in verapamil overdose – Case Report and antidotes review

Marzęda¹,

Drozd²,

Tchórz³

et al. 2021

J Pre Clin Clin Res.

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Introduction.Verapamil is a widely used cardiac drug. It belongs to the non-dihydropiridine subgroup of calcium channel blockers (CCBs), and is used mainly for the treatment of atrial dysrhythmias, hypertension or angina. In this article, we describe a case of poisoning with verapamil mixed with ethanol and review current treatment options. A 54-year-old female was admitted to the Toxicology Clinic by emergency medical services after ingesting sustained-release CCBs and ethanol in a suicidal attempt. The patient was successfully treated by administration of catecholamines and calcium, and the introduction of a high-dose insulin infusion (HDI). Conclusions. This case report emphasizes that even in severe poisoning, early and proper intervention may prevent circulatory breakdown. It also summarizes treatment options in patients after verapamil overdose. Along with decontamination, administration of catecholamines and correcting electrolyte abnormalities, the main options are HDI and lipid emulsion therapy (LET).

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“…Positive inotropic agents are frequently used in patients with decompensating heart failure and left ventricular systolic dysfunction. For this reason, beta-adrenergic drugs, dobutamine and dopamine, or phosphodiesterase inhibitors, milrinone and enoximone, are often administered however, these agents have been reported to increase morbidity and mortality in heart failure [2,3]. Levosimendan is a calcium sensitizer that has a positive inotropic action as well as peripheral and coronary vasodilation by opening of the ATP-sensitive potassium channels [4].…”

Section: Introductionmentioning

confidence: 99%

“…In the vascular smooth muscle, vasodilatation occurs by the opening of the ATP related K+ channels. In summary, the clinical effects of the levosimendan are related to its inotropic action, decrease in preload and afterload along with no increase in myocardial oxygen demand [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

The effects of levosimendan on renal functions in open-heart surgery patients with a low ejection fraction

Yazici¹,

Karabulut²,

Baysal³

et al. 2021

J Clin Invest Surg.

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Purpose. This study investigated the effects of levosimendan on renal functions in patients with a preoperative low ejection fraction undergoing open-heart surgery and cardiopulmonary bypass (CPB). Materials and Methods. The study retrospectively evaluated 64 patients with a diagnosis of mitral valve insufficiency and left ventricular dysfunction undergoing open-heart surgery with CPB. Patients were divided depending on the preoperative blood creatinine level less (Group 1) or more than 1.2 mg/dL (Group 2). A bolus dose of levosimendan was administered through the aortic arch at the end of the CPB, preceding an infusion of levosimendan intravenously in all patients. Demographic data, preoperative and 48-hour postoperative echocardiographic studies were done. The blood urea and creatinine levels were collected preoperatively and on postoperative days 1, 3, and 10. The use of inotropic support, intra-aortic balloon pump, and complications were recorded. Results. The demographic data were similar between groups (p>0.05). Preoperative serum creatinine levels were higher in Group 1 in comparison to Group 2 (p=0.01, p<0.001, respectively). The aortic cross-clamp and cardiopulmonary bypass times were similar between groups (p>0.05). Preoperative serum creatinine levels were higher in Group 1 in comparison to Group 2 (p<0.001). On postoperative day 1, serum creatinine levels of Group 1 were significantly lower than Group 2 (p<0.001). On postoperative days 3 and 10, no differences were observed regarding serum creatinine levels between groups (p>0.05). Complications were similar between groups (p>0.05). Conclusions. In patients with low ejection fraction undergoing open-heart surgery, the use of levosimendan intraoperatively and 24 hours postoperatively prevents deterioration of renal functions in patients with or without preoperative disturbance in serum creatinine level.

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Levosimendan in the modern treatment of patients with acute heart failure of various aetiologies

Cited by 4 publications

References 46 publications

Role of inhaled levosimendan in peripartum cardiomyopathy

Role of inhaled levosimendan in peripartum cardiomyopathy

Importance of early intervention in verapamil overdose – Case Report and antidotes review

The effects of levosimendan on renal functions in open-heart surgery patients with a low ejection fraction

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