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

Parle, N.M.; Thomas, Martín; Dembo, L.; Best, Matthew J.; Driscoll, G.O.’

doi:10.1016/j.hlc.2007.10.014

Cited by 33 publications

(35 citation statements)

References 19 publications

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“…At 6 months, mortality rate favored levosimendan both versus dobutamine alone (19% vs 38%, p = 0.037) and versus the combination group (19% vs 48%, p = 0.009). Similar improvements in the functional capacity of patients receiving repetitive levosimendan (from 2 to 26 times, with a mean dosing interval of 66.2 ± 12 days) were observed also in another singlecentre, prospective, non-randomized study, by Parle et al [45].…”

Section: Clinical Studies On the Effects Of Levosimendan In Adhfsupporting

confidence: 74%

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Pölzl¹,

Altenberger

Baholli

et al. 2017

International Journal of Cardiology

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Section: Clinical Studies On the Effects Of Levosimendan In Adhfsupporting

confidence: 74%

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Pölzl¹,

Altenberger

Baholli

et al. 2017

International Journal of Cardiology

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“…Moreover, the small numbers of patients involved did not permit any analysis of mortality or arrhythmic risk correlated to levosimendan infusion – these questions need to be addressed by a larger, randomized trial. Nevertheless, our limited experience suggests caution using an infusion pump for levosimendan infusion in out-patients with chronic, refractory CHF [34], eventually limiting such therapy in subjects protected by an AICD. In fact, in our experience a ventricular arrhythmic disorder occurred in 10% of levosimendan treatment, while in the LIDO trial it was recorded in only 4% of patients treated [8].…”

Section: Discussionmentioning

confidence: 99%

Effects of levosimendan/furosemide infusion on Plasma Brain Natriuretic Peptide, echocardiographic parameters and cardiac output in end-stage heart failure patients

et al. 2011

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SummaryBackgroundAcute decompensation heart failure (ADHF) remains a cause of hospitalization in patients with end-stage congestive HF. The administration of levosimendan in comparison with a standard therapy in CHF patients admitted for ADHF was analysed.Material/MethodsConsecutive patients admitted for ADHF (NYHA class III–IV) were treated with levosimendan infusion 0.1 μg/kg/min or with furosemide infusion 100–160 mg per day for 48 hours (control group). All subjects underwent determination of brain natriuretic peptide (BNP), non-invasive cardiac output (CO), and echocardiogram at baseline, at the end of therapy and 1 week after therapy.ResultsSeven patients admitted for 20 treatments in 16 months (age 66 years; mean admission/year 5.4) were treated with levosimendan and compared with 7 patients admitted for 15 treatments (age 69.1 years; mean admission/year 6.1). At the end of levosimendan therapy, BNP decreased (from 679.7±512.1 pg/ml to 554.2±407.6 pg/ml p=0.03), and 6MWT and LVEF improved (from 217.6±97.7 m to 372.2±90.4 m p=0.0001; from 22.8±9.1% to 25.4±9.8% p=0.05). Deceleration time, E/A, E/E’, TAPSE, pulmonary pressure and CO did not change significantly after levosimendan therapy and after 1 week. At follow-up, only 6-min WT and NYHA class showed a significant improvement (p=0.0001, p=0.001 respectively). The furosemide infusion reduced NYHA class and body weight (from 3.4±0.6 to 2.3±0.5 p=0.001; from 77.5±8.6 kg to 76±6.6 kg p=0.04), but impaired renal function (clearances from 56.3±21.9 ml/min to 41.2±10.1 ml/min p=0.04).ConclusionsTreating end-stage CHF patients with levosimendan improved BNP and LVEF, but this effect disappeared after 1 week. The amelioration of 6MWT and NYHA class lasted longer after levosimendan infusion.

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“…In a study by Parissis et al, functional capacity and scores of emotional stress favoured levosimendan over placebo [52]. Trials assessing the effects of repetitive administration have yielded improvements regarding functional capacity, left ventricular ejection fraction, and quality-of-life scores [53][54][55]. Potential explanations for these effects relate to levosimendan-mediated, sustained reductions in inflammatory cytokines and apoptotic factors [56,57].…”

Section: Levosimendanmentioning

confidence: 99%

The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations

Nieminen¹,

Dickstein²,

Fonseca³

et al. 2015

International Journal of Cardiology

138

104

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End of life is an unfortunate but inevitable phase of the heart failure patients' journey. It is often preceded by a stage in the progression of heart failure defined as advanced heart failure, and characterised by poor quality of life and frequent hospitalisations. In clinical practice, the efficacy of treatments for advanced heart failure is often assessed by parameters such as clinical status, haemodynamics, neurohormonal status, and echo/MRI indices. From the patients' perspective, however, quality-of-life-related parameters, such as functional capacity, exercise performance, psychological status, and frequency of re-hospitalisations, are more significant. The effects of therapies and interventions on these parameters are, however, underrepresented in clinical trials targeted to assess advanced heart failure treatment efficacy, and data are overall scarce. This is possibly due to a non-universal definition of the quality-of-life-related endpoints, and to the difficult standardisation of the data collection. These uncertainties also lead to difficulties in handling trade-off decisions between quality of life and survival by patients, families and healthcare providers. A panel of 34 experts in the field of cardiology and intensive cardiac care from 21 countries around the world convened for reviewing the existing data on quality-of-life in patients with advanced heart failure, discussing and reaching a consensus on the validity and significance of quality-of-life assessment methods. Gaps in routine care and research, which should be addressed, were identified. Finally, published data on the effects of current i.v. vasoactive therapies such as inotropes, inodilators, and vasodilators on quality-of-life in advanced heart failure patients were analysed.

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

Cited by 33 publications

References 19 publications

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Effects of levosimendan/furosemide infusion on Plasma Brain Natriuretic Peptide, echocardiographic parameters and cardiac output in end-stage heart failure patients

The patient perspective: Quality of life in advanced heart failure with frequent hospitalisations

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