PMID- 33269816
OWN - NLM
STAT- MEDLINE
DCOM- 20210125
LR  - 20210125
IS  - 1899-5276 (Print)
IS  - 1899-5276 (Linking)
VI  - 29
IP  - 11
DP  - 2020 Nov
TI  - Multicenter experiences with levosimendan therapy and its safety in patients with 
      decompensated advanced heart failure.
PG  - 1305-1312
LID - 10.17219/acem/126301 [doi]
AB  - BACKGROUND: Advanced heart failure (AdvHF) is associated with high morbidity and 
      mortality. Patients with this clinical condition are potential candidates for 
      heart transplantation or mechanical circulatory support. Initially, however, they 
      are usually supported with inotropic drugs. Recent studies have suggested that 
      levosimendan, independently of hemodynamic improvements, may lead to outcome 
      benefits. OBJECTIVES: To present clinical experiences concerning the indications, 
      effectiveness, tolerance, and safety of levosimendan in the real-life therapy of 
      patients with decompensated AdvHF in 3 cardiac centers in Poland. MATERIAL AND 
      METHODS: This is a prospective, observational, three-center study. Forty-nine 
      patients with AdvHF admitted with decompensation were included (88% men, mean age 
      58 years, 65% ischemic etiology, left ventricular ejection fraction (LVEF) in 
      median 20%) and followed up for an early (3 months) and prolonged period (1 year) 
      after infusion of levosimendan. Patients were analyzed in relation to death. 
      RESULTS: Levosimendan therapy was associated with reduced HF symptoms and signs, 
      New York Heart Association (NYHA) class and level of B-type natriuretic peptide 
      (BNP) at discharge. Five patients died during hospitalization, a further 10 
      during the three-month follow-up and 3 died during the next nine-month follow-up. 
      During the three-month follow-up, 22 patients were re-hospitalized due to HF and 
      in the next nine-month follow-up 8 were re-hospitalized. A multivariate analysis 
      indicated the QRS duration at discharge (hazard ratio (HR) = 1.02; 95% confidence 
      interval (95% CI) = 1.003-1.03; p = 0.018), high-sensitivity C-reactive protein 
      (hsCRP) (HR = 1.01; 95% CI = 1.004-1.02; p = 0.002), and simultaneous dobutamine 
      infusion (HR = 6.54; 95% CI = 1.4-30.5; p = 0.017) were independent risk factors 
      for death in the one-year follow-up. There were no side effects leading to the 
      interruption of the levosimendan infusion. CONCLUSIONS: The use of levosimendan 
      was safe and associated with clinical improvement and reduction in BNP level in 
      AdvHF patients hospitalized due to HF decompensation, although the mortality and 
      re-hospitalization rate during the one-year follow-up remains high.
FAU - Lelonek, Malgorzata
AU  - Lelonek M
AD  - Department of Noninvasive Cardiology, Medical University of Lodz, Poland.
FAU - Stopczynska, Iwona
AU  - Stopczynska I
AD  - 1st Department of Cardiology, Medical University of Gdansk, Poland.
FAU - Koroscik, Ewa
AU  - Koroscik E
AD  - 1st Department of Cardiology, Poznan University of Medical Sciences, Poland.
FAU - Straburzynska-Migaj, Ewa
AU  - Straburzynska-Migaj E
AD  - 1st Department of Cardiology, Poznan University of Medical Sciences, Poland.
FAU - Gruchala, Marcin
AU  - Gruchala M
AD  - 1st Department of Cardiology, Medical University of Gdansk, Poland.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - Poland
TA  - Adv Clin Exp Med
JT  - Advances in clinical and experimental medicine : official organ Wroclaw Medical 
      University
JID - 101138582
RN  - 0 (Cardiotonic Agents)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 349552KRHK (Simendan)
SB  - IM
MH  - Cardiotonic Agents/adverse effects
MH  - Female
MH  - *Heart Failure/diagnosis/drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain
MH  - Poland
MH  - Prospective Studies
MH  - Simendan/pharmacology
MH  - Stroke Volume
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - advanced heart failure
OT  - levosimendan
OT  - prognosis
EDAT- 2020/12/04 06:00
MHDA- 2021/01/26 06:00
CRDT- 2020/12/03 08:35
PHST- 2020/12/03 08:35 [entrez]
PHST- 2020/12/04 06:00 [pubmed]
PHST- 2021/01/26 06:00 [medline]
AID - 10.17219/acem/126301 [doi]
PST - ppublish
SO  - Adv Clin Exp Med. 2020 Nov;29(11):1305-1312. doi: 10.17219/acem/126301.