[Therapy of acute decompensated heart failure with levosimendan].

Abstract

PURPOSE:

To determine the short-term hemodynamic and clinical effects of levosimendan, a calcium-sensitizing agent, in patients with decompensated heart failure.

PATIENTS AND METHODS:

Seven patients with cardiogenic shock requiring catecholamines (two patients with acute myocardial infarction, two patients with decompensated hypertensive heart disease, one patient with low cardiac output with ischemic cardiomyopathy, two patients with dilated cardiomyopathy [ethyl-toxic, polymyositis] with a cardiac index < or = 2.5 ) 1 x min(-1) x m(-2) and a pulmonary wedge pressure > or = 15 mmHg received levosimendan with an initial loading dose of 12 microg/kg over 10 min followed by a continuous infusion of 0.1 microg/kg/min for 24 h.

RESULTS:

During levosimendan infusion an increase in cardiac index (30% after 6 h and 24 h), a decrease in heart rate (4% after 6 h and 10% after 24 h, respectively), and a decrease in systemic vascular resistance (27% after 6 h and 41% after 24 h, respectively) appeared. In combination with volume resuscitation the pulmonary capillary wedge pressure increased. Under therapy with levosimendan no relevant adverse events occurred; there was no increase in severe cardiac arrhythmias and QT interval duration.

CONCLUSION:

Levosimendan causes rapid improvement in hemodynamic function in patients with cardiogenic shock. These hemodynamic effects are not associated with relevant adverse events. Levosimendan may be of value in the short-term management of patients with cardiogenic shock.

• Authors: Karin Müller, Ansgar Peters, Tobias Zeus, Markus Hennersdorf, Bodo Eckehard Strauer
• Journal: Medizinische Klinik (Munich, Germany : 1983) (Med Klin (Munich)) Vol. 101 Suppl 1 Pg. 119-22 (Mar 22 2006) ISSN: 0723-5003 [Print] Germany
• Vernacular Title: Akute hämodynamische und klinische Effekte von Levosimendan in der Therapie des kardiogenen Schocks.
• PMID: 16802535 (Publication Type: Journal Article)

Chemical References

• Calcium Channel Agonists
• Cardiotonic Agents
• Hydrazones
• Pyridazines
• Simendan
• Dobutamine
• Norepinephrine

Topics

• Adult
• Aged
• Calcium Channel Agonists (administration & dosage, adverse effects)
• Cardiotonic Agents (administration & dosage, adverse effects)
• Conscious Sedation
• Critical Care
• Dobutamine (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Drug Therapy, Combination
• Electrocardiography (drug effects)
• Female
• Heart Failure (drug therapy)
• Hemodynamics (drug effects)
• Humans
• Hydrazones (administration & dosage, adverse effects)
• Male
• Middle Aged
• Norepinephrine (administration & dosage, adverse effects)
• Pyridazines (administration & dosage, adverse effects)
• Shock, Cardiogenic (drug therapy)
• Simendan