PMID- 33839989
OWN - NLM
STAT- MEDLINE
DCOM- 20220429
LR  - 20220429
IS  - 1573-7322 (Electronic)
IS  - 1382-4147 (Print)
IS  - 1382-4147 (Linking)
VI  - 27
IP  - 2
DP  - 2022 Mar
TI  - Intermittent levosimendan infusion in ambulatory patients with end-stage heart 
      failure: a systematic review and meta-analysis of 984 patients.
PG  - 493-505
LID - 10.1007/s10741-021-10101-0 [doi]
AB  - We sought to synthesize the available evidence regarding safety and efficacy of 
      intermittent levosimendan (LEVO) infusions in ambulatory patients with end-stage 
      heart failure (HF). Safety and efficacy of ambulatory intermittent LEVO infusion 
      in patients with end-stage HF are yet not established. We systematically searched 
      MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane databases, from inception 
      to January 30, 2021 for studies reporting outcome of adult ambulatory patients 
      with end-stage HF treated with intermittent LEVO infusion. Fifteen studies (8 
      randomized and 7 observational) comprised 984 patients (LEVO [N = 727] and 
      controls [N = 257]) met the inclusion criteria. LEVO was associated with improved 
      New York Heart Association (NYHA) functional class (weighted mean difference 
      [WMD] -1.04, 95%CI: -1.70 to -0.38, p < 0.001, 5 studies, I(2) = 93%), improved 
      left ventricular (LV) ejection fraction (WMD 4.0%, 95%CI: 2.8% to 5.3%, 
      p < 0.001, 6 studies, I(2) = 9%), and reduced BNP levels (WMD -549 pg/mL, 95%CI 
      -866 to -233, p < 0001, 3 studies, I(2) = 66%). All-cause death was not different 
      (RR 0.65, 95%CI: 0.38 to 1.093, p = 0.10, 6 studies, I(2) = 0), but 
      cardiovascular death was lower on LEVO (RR 0.34, 95%CI: 0.13 to 0.87, p = 0.02, 3 
      studies, I(2) = 0) compared to controls. Furthermore, health-related quality of 
      life (HRQoL) was improved alongside with reduced LV size following LEVO 
      infusions. Major adverse events were not different between LEVO and placebo. In 
      conclusion, intermittent LEVO infusions in ambulatory patients with end-stage HF 
      is associated with less frequent cardiovascular death alongside with improved 
      NYHA class, quality of life, BNP levels, and LV function. However, the current 
      evidence is limited by heterogeneous and relatively small studies.
CI  - (c) 2021. The Author(s).
FAU - Elsherbini, Hagar
AU  - Elsherbini H
AD  - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
AD  - Utrecht University of Applied Sciences, Utrecht, Netherlands.
FAU - Soliman, Osama
AU  - Soliman O
AUID- ORCID: 0000-0003-0758-3539
AD  - Department of Cardiology, National University of Ireland, Galway, Ireland. 
      o.i.soliman@gmail.com.
FAU - Zijderhand, Casper
AU  - Zijderhand C
AD  - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Lenzen, Mattie
AU  - Lenzen M
AD  - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Hoeks, Sanne E
AU  - Hoeks SE
AD  - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Kaddoura, Rasha
AU  - Kaddoura R
AD  - Department of Clinical Pharmacy, Hamad Medical Corporation, Doha, Qatar.
FAU - Izham, Mohamed
AU  - Izham M
AD  - College of Pharmacy, QU Health, Qatar University, Doha, Qatar.
FAU - Alkhulaifi, Abdulaziz
AU  - Alkhulaifi A
AD  - Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU, Heart Hospital, 
      Hamad Medical Corporation, Doha, Qatar.
FAU - Omar, Amr S
AU  - Omar AS
AD  - Department of Cardiothoracic Surgery/Cardiac Anaesthesia & ICU, Heart Hospital, 
      Hamad Medical Corporation, Doha, Qatar.
AD  - Department of Critical Care Medicine, Beni Suef University, Beni Suef, Egypt.
AD  - Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
FAU - Caliskan, Kadir
AU  - Caliskan K
AD  - Department of Cardiology, Erasmus University Medical Centre, Rotterdam, 
      Netherlands. dr.kcaliskan@hotmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20210411
PL  - United States
TA  - Heart Fail Rev
JT  - Heart failure reviews
JID - 9612481
RN  - 349552KRHK (Simendan)
SB  - IM
EIN - Heart Fail Rev. 2021 Jun 21;:. PMID: 34151396
MH  - Adult
MH  - *Heart Failure
MH  - Humans
MH  - Quality of Life
MH  - Simendan/therapeutic use
MH  - Stroke Volume
MH  - Ventricular Function, Left
PMC - PMC8898255
OTO - NOTNLM
OT  - Ambulatory
OT  - Efficacy
OT  - Functional capacity
OT  - Heart failure
OT  - Levosimendan
OT  - Safety
OT  - Survival
COIS- The authors declare no competing interests.
EDAT- 2021/04/12 06:00
MHDA- 2022/04/30 06:00
PMCR- 2021/04/11
CRDT- 2021/04/11 20:56
PHST- 2021/03/26 00:00 [accepted]
PHST- 2021/04/12 06:00 [pubmed]
PHST- 2022/04/30 06:00 [medline]
PHST- 2021/04/11 20:56 [entrez]
PHST- 2021/04/11 00:00 [pmc-release]
AID - 10.1007/s10741-021-10101-0 [pii]
AID - 10101 [pii]
AID - 10.1007/s10741-021-10101-0 [doi]
PST - ppublish
SO  - Heart Fail Rev. 2022 Mar;27(2):493-505. doi: 10.1007/s10741-021-10101-0. Epub 
      2021 Apr 11.