Randomized study on safety and effectiveness of levosimendan in patients with left ventricular failure after an acute myocardial infarct

Moiseyev, V.S.; Andrejevs, N.; Lehtonen, Lasse; Lie, Ki; Ruda, Michail Y.; Kobalava, Zh. D.; Põder, Pentti; Nieminen, Markku S.

doi:10.1016/s1071-9164(99)91501-4

Cited by 6 publications

(8 citation statements)

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“…Improvement in left ventricular hemodynamics in our patients was in accordance with findings in previous studies [10,11,13,14]. A 24-h course of levosimendan resulted in a significant increase in CI along with a significant decrease in SVR and left ventricular preload.…”

Section: Discussionsupporting

confidence: 92%

“…The substance increases calcium sensitivity of myofilaments by directly targeting troponin C and activating adenosine triphosphate-sensitive potassium (K + ) channels in the heart and systemic arteries [8,9]. In clinical trials' treatment of acute heart failure patients, levosimendan was associated with beneficial hemodynamic effects as well as a favorable impact on mortality [10][11][12]. However, only few data is available on the effects of levosimendan in patients with biventricular or predominant right ventricular failure.…”

Section: Introductionmentioning

confidence: 99%

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Safety and Effectiveness of Levosimendan in Patients with Predominant Right Heart Failure

Poelzl

Zwick

Grander³

et al. 2008

Herz

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Safety and Effectiveness of Levosimendan in Patients with Predominant Right Heart Failure

Poelzl

Zwick

Grander³

et al. 2008

Herz

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“…Six-month mortality in patients randomized to levosimendan was 15.3%, while the mortality rate in the placebo and dobutamine groups were 24.7% and 39.6% respectively. In the setting of pulmonary edema within 5 days of an acute myocardial infarction, short-term intravenous infusion of levosimendan was associated with reduction of worsening heart failure without risk of hypotension and ischemia compared with placebo in the RUSSLAN (Randomized Study on Safety and Effectiveness of Levosimendan in patients with left ventricular failure after an Acute myocardial InfarctioN study [45]. Levosimendan has been approved in many countries for the treatment of low-output heart failure, primarily based on data from the LIDO study.…”

Section: Calcium Sensitizers / Phosphodiesterase Inhibitorsmentioning

confidence: 99%

Novel Strategies for the Management of Acute Decompensated Heart Failure

Tang¹,

Hobbs²

2005

CCR

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Acute decompensated heart failure (ADHF) is the primary diagnosis for approximately one million hospital admissions in the United States, with an estimated $13.6 billion dollars of direct hospital cost in 2003. Until recently, diagnosis and management of ADHF has largely been "tradition-based" rather than evidence-based. Diuretic therapy has been the mainstay of symptom relief for pulmonary congestion and fluid retention. The introduction of nesiritide has revived the emphasis on vasodilator therapy for preload and afterload reduction in ADHF. Newer intravenous vasodilator drugs such as tezosentan, an endothelin antagonist, and carperitide, a natriuretic peptide, currently are being tested in multicenter clinical trials. New inotropic agents, such as levosimendan, appear to have an improved safety and efficacy profile. Vasopressin receptor antagonists and adenosine receptor antagonists may offer improved renal preservation during aggressive diuresis. Mechanical unloading with ultrafiltration devices and extracorporeal circulatory support devices have been developed to supplement pharmacological therapies and are undergoing clinical trials.

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“…It promotes contractile and hemodynamic improvement similar to other inotropic drugs and has a vasodilator action by activating ATPdependent potassium channels (29) . Levosimendan is safe and efficient in DHF of different etiologies, especially in patients using betablockers (30,31) . Its half-life is long, with active metabolites maintaining their effect for up to 7 days.…”

Section: Levosimendanmentioning

confidence: 99%

Decompensated Heart Failure

&NA;

2003

The Nurse Practitioner

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Heart failure is a disease with high incidence and prevalence in the population. The costs with hospitalization for decompensated heart failure reach approximately 60% of the total cost with heart failure treatment, and mortality during hospitalization varies according to the studied population, and could achieve values of 10%. In patients with decompensated heart failure, history and physical examination are of great value for the diagnosis of the syndrome, and also can help the physician to identify the beginning of symptoms, and give information about etiology, causes and prognosis of the disease. The initial objective of decompensated heart failure treatment is the hemodynamic and symptomatic improvement preservation and/or improvement of renal function, prevention of myocardial damage, modulation of the neurohormonal and/or inflammatory activation and control of comorbidities that can cause or contribute to progression of the syndrome. According to the clinical-hemodynamic profile, it is possible to establish a rational for the treatment of decompensated heart failure, individualizing the proceedings to be held, leading to reduction in the period of hospitalization and consequently reducing overall mortality.Keywords: Heart failure/diagnosis; Heart failure/therapy; Prognosis RESUMO A insuficiência cardíaca apresenta elevada incidência e prevalência em todo mundo. Os custos com internação por insuficiência cardíaca descompensada chegam a aproximadamente 60% do custo total do tratamento da insuficiência cardíaca, e a mortalidade durante a internação varia conforme a população estudada, podendo chegar a 10%. Em pacientes com insuficiência cardíaca descompensada, os achados de história e exame físico são de grande valor por fornecerem, além do diagnóstico da síndrome, o tempo de início dos sintomas, as informações sobre etiologia, as causas de descompensação e o prognóstico. O objetivo inicial do tratamento da insuficiência cardíaca descompensada é a melhora hemodinâmica e sintomática. Além disso, outros alvos devem ser buscados, incluindo preservação e/ou melhora da função renal, prevenção de lesão miocárdica, modulação da ativação neuro-hormonal e/ou inflamatória, e manejo de comorbidades que podem causar ou contribuir para progressão da síndrome. Com base nos perfis clínico-hemodinâmicos, é possível estabelecer um racional para o tratamento da insuficiência cardíaca descompensada, individualizando o procedimento a ser instituído e objetivando redução de tempo de internação e de mortalidade.

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Randomized study on safety and effectiveness of levosimendan in patients with left ventricular failure after an acute myocardial infarct

Cited by 6 publications

References 0 publications

Safety and Effectiveness of Levosimendan in Patients with Predominant Right Heart Failure

Safety and Effectiveness of Levosimendan in Patients with Predominant Right Heart Failure

Novel Strategies for the Management of Acute Decompensated Heart Failure

Decompensated Heart Failure

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