PMID- 25806830
OWN - NLM
STAT- MEDLINE
DCOM- 20151207
LR  - 20181202
IS  - 1748-295X (Electronic)
IS  - 1748-2941 (Linking)
VI  - 17
IP  - 1
DP  - 2015 Mar
TI  - Effects of levosimendan on heart failure in normotensive patients: does loading 
      dose matter?
PG  - 14-9
LID - 10.3109/17482941.2015.1005102 [doi]
AB  - BACKGROUND: Levosimendan is a calcium sensitizer and K(+)-ATP channel opener with 
      inotropic and vasodilatatory effects irrespective of myocardial oxygen 
      consumption, used for treatment of heart failure (HF). A loading dose is usually 
      given by infusion for 12 h; however, profound lowering of blood pressure often 
      disrupts or prolongs the infusion. The aim of this study was to assess clinical, 
      biochemical and myocardial differences between different regimes of levosimendan 
      therapy, with or without loading dose, and compared to standard therapy in heart 
      failure. METHODS: Fifty-seven patients (mean age +/- SD: 60.9 +/- 9.3 years, 45 
      males) with HF, New York Heart Association (NYHA) III-IV, reduced left 
      ventricular ejection fraction (LVEF) were included. Twenty patients (NB group) 
      were given levosimendan without loading dose, 14 patients (B group) were given 
      levosimendan with loading dose, and 23 patients (C group) were given standard 
      therapy. Clinical, biochemical and echocardiographic characteristics at baseline 
      and one week after treatment were evaluated. RESULTS: Groups were similar at 
      baseline. After one week NHYA class (P < 0.001), NT pro-BNP (P < 0.001), LVEF (P 
      = 0.045), E/A (P = 0.048) E/e' (P < 0.001), and PAPs (P < 0.001) decreased. DT (P 
      = 0.011) and TAPSE (P = 0.035) increased in all groups. CONCLUSIONS: 
      Levosimendan, as well as standard therapy, improves myocardial function and 
      symptoms of HF, irrespective of the loading dose administration. Treatment 
      options for patients with end-stage heart failure refractory to conventional 
      medical therapy are limited. Inotropic drugs play an important role in heart 
      failure (HF).
FAU - Palmerini, Elisabetta
AU  - Palmerini E
AD  - Department of Cardiovascular Diseases, Siena University Hospital , Siena , Italy.
FAU - Soderberg, Stefan
AU  - Soderberg S
FAU - Mondillo, Sergio
AU  - Mondillo S
FAU - Favilli, Roberto
AU  - Favilli R
FAU - Lunghetti, Stefano
AU  - Lunghetti S
LA  - eng
PT  - Journal Article
DEP - 20150325
PL  - England
TA  - Acute Card Care
JT  - Acute cardiac care
JID - 101276603
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Hydrazones)
RN  - 0 (Peptide Fragments)
RN  - 0 (Pyridazines)
RN  - 0 (Vasodilator Agents)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 349552KRHK (Simendan)
SB  - IM
MH  - Cardiotonic Agents/*administration & dosage
MH  - Drug Administration Schedule
MH  - Female
MH  - Heart Failure/diagnostic imaging/*drug therapy/physiopathology
MH  - Hemodynamics
MH  - Humans
MH  - Hydrazones/*administration & dosage
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/blood
MH  - Peptide Fragments/blood
MH  - Pyridazines/*administration & dosage
MH  - Simendan
MH  - Ultrasonography
MH  - Vasodilator Agents/*administration & dosage
OTO - NOTNLM
OT  - Echocardiography
OT  - heart failure
OT  - natriuretic peptides
EDAT- 2015/03/26 06:00
MHDA- 2015/12/15 06:00
CRDT- 2015/03/26 06:00
PHST- 2015/03/26 06:00 [entrez]
PHST- 2015/03/26 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - 10.3109/17482941.2015.1005102 [doi]
PST - ppublish
SO  - Acute Card Care. 2015 Mar;17(1):14-9. doi: 10.3109/17482941.2015.1005102. Epub 
      2015 Mar 25.