PMID- 29469177
OWN - NLM
STAT- MEDLINE
DCOM- 20181217
LR  - 20240324
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 5
IP  - 3
DP  - 2018 Jun
TI  - Haemodynamic effects of levosimendan in advanced but stable chronic heart 
      failure.
PG  - 302-308
LID - 10.1002/ehf2.12272 [doi]
AB  - AIMS: Levosimendan improves haemodynamics in acute decompensated heart failure 
      (HF). However, it is increasingly used for repetitive or intermittent infusions 
      in advanced but stable chronic HF, without clear indication, selection criteria, 
      or effect. We tested the hypotheses that (1) levosimendan improves haemodynamics 
      in stable chronic HF and (2) that the response is dependent on baseline clinical 
      and haemodynamic factors. METHODS AND RESULTS: Twenty-three patients [median age 
      56 (49-64) years, four (17%) women] with stable New York Heart Association (NYHA) 
      III and IV HF received a single 24 h levosimendan infusion. Non-invasive 
      haemodynamics (inert gas re-breathing technique), estimated glomerular filtration 
      rate, and N-terminal pro-brain natriuretic peptide were assessed before and after 
      infusion. Levosimendan had the following effects (median change): a significant 
      increase in cardiac output (+9.8 +/- 21.6%; P = 0.026) and decrease in N-terminal 
      pro-brain natriuretic peptide (-28.1 +/- 16.3%, P < 0.001), estimated total 
      peripheral resistance (-16.9 +/- 18.3%, P = 0.005), and mean arterial pressure 
      (-5.9 +/- 8.2%, P = 0.007), but no change in estimated glomerular filtration rate 
      (+0.89 +/- 14.0%, P = 0.955). There were no significant associations between 
      baseline clinical and/or haemodynamic factors and the levosimendan effect on 
      cardiac output. CONCLUSIONS: Levosimendan was associated with improved 
      haemodynamics in patients with stable chronic HF, but we could not identify any 
      predictors of the magnitude of haemodynamic response.
CI  - (c) 2018 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of the European Society of Cardiology.
FAU - Najjar, Emil
AU  - Najjar E
AD  - Department of Medicine, Karolinska Institutet, 17177, Stockholm, Sweden.
AD  - Department of Cardiology, Karolinska University Hospital, 17176, Stockholm, 
      Sweden.
FAU - Stalhberg, Marcus
AU  - Stalhberg M
AD  - Department of Medicine, Karolinska Institutet, 17177, Stockholm, Sweden.
AD  - Department of Cardiology, Karolinska University Hospital, 17176, Stockholm, 
      Sweden.
FAU - Hage, Camilla
AU  - Hage C
AD  - Department of Medicine, Karolinska Institutet, 17177, Stockholm, Sweden.
AD  - Department of Cardiology, Karolinska University Hospital, 17176, Stockholm, 
      Sweden.
FAU - Ottenblad, Erica
AU  - Ottenblad E
AD  - Department of Cardiology, Karolinska University Hospital, 17176, Stockholm, 
      Sweden.
FAU - Manouras, Aristomenis
AU  - Manouras A
AD  - Department of Medicine, Karolinska Institutet, 17177, Stockholm, Sweden.
AD  - Department of Cardiology, Karolinska University Hospital, 17176, Stockholm, 
      Sweden.
FAU - Haugen Lofman, Ida
AU  - Haugen Lofman I
AD  - Department of Medicine, Karolinska Institutet, 17177, Stockholm, Sweden.
AD  - Department of Cardiology, Karolinska University Hospital, 17176, Stockholm, 
      Sweden.
FAU - Lund, Lars H
AU  - Lund LH
AD  - Department of Medicine, Karolinska Institutet, 17177, Stockholm, Sweden.
AD  - Department of Cardiology, Karolinska University Hospital, 17176, Stockholm, 
      Sweden.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20180222
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
RN  - 0 (Cardiotonic Agents)
RN  - 349552KRHK (Simendan)
SB  - IM
MH  - Cardiotonic Agents/administration & dosage
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Hemodynamics/drug effects/*ethics
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Simendan/*administration & dosage
MH  - Treatment Outcome
PMC - PMC5933961
OTO - NOTNLM
OT  - Cardiac output
OT  - Heart failure
OT  - Inodilator
OT  - Inotrope
OT  - Levosimendan
OT  - Repetitive treatment
EDAT- 2018/02/23 06:00
MHDA- 2018/12/18 06:00
PMCR- 2018/02/22
CRDT- 2018/02/23 06:00
PHST- 2017/06/07 00:00 [received]
PHST- 2017/12/06 00:00 [revised]
PHST- 2018/01/09 00:00 [accepted]
PHST- 2018/02/23 06:00 [pubmed]
PHST- 2018/12/18 06:00 [medline]
PHST- 2018/02/23 06:00 [entrez]
PHST- 2018/02/22 00:00 [pmc-release]
AID - EHF212272 [pii]
AID - 10.1002/ehf2.12272 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2018 Jun;5(3):302-308. doi: 10.1002/ehf2.12272. Epub 2018 Feb 22.