Levosimendan in Acute and Advanced Heart Failure : an Expert Perspective on Posology and Therapeutic Application

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Bouchez , S , Fedele , F , Giannakoulas , G , Gustafsson , F , Harjola , V -P , Karason , K , Kivikko , M , von Lewinski , D , Oliva , F , Papp , Z , Parissis , J , Pollesello , P , Pölzl , G & Tschöpe , C 2018 , ' Levosimendan in Acute and Advanced Heart Failure : an Expert Perspective on Posology and Therapeutic Application ' , Cardiovascular Drugs and Therapy , vol. 32 , no. 6 , pp. 617-624 . https://doi.org/10.1007/s10557-018-6838-2

Title: Levosimendan in Acute and Advanced Heart Failure : an Expert Perspective on Posology and Therapeutic Application
Author: Bouchez, S.; Fedele, F.; Giannakoulas, G.; Gustafsson, F.; Harjola, V. -P.; Karason, K.; Kivikko, M.; von Lewinski, D.; Oliva, F.; Papp, Z.; Parissis, J.; Pollesello, Piero; Pölzl, G.; Tschöpe, C.
Contributor organization: HUS Emergency Medicine and Services
Department of Medicine
Kardiologian yksikkö
HUS Internal Medicine and Rehabilitation
HUS Heart and Lung Center
Date: 2018-12
Language: eng
Number of pages: 8
Belongs to series: Cardiovascular Drugs and Therapy
ISSN: 0920-3206
DOI: https://doi.org/10.1007/s10557-018-6838-2
URI: http://hdl.handle.net/10138/278324
Abstract: Levosimendan, a calcium sensitizer and potassium channel-opener, is widely appreciated by many specialist heart failure practitioners for its effects on systemic and pulmonary hemodynamics and for the relief of symptoms of acute heart failure. The drug's impact on mortality in large randomized controlled trials has been inconsistent or inconclusive but, in contrast to conventional inotropes, there have been no indications of worsened survival and some signals of improved heart failure-related quality of life. For this reason, levosimendan has been proposed as a safer inodilator option than traditional agents in settings, such as advanced heart failure. Positive effects of levosimendan on renal function have also been described. At the HEART FAILURE 2018 congress of the Heart Failure Association of the European Society of Cardiology, safe and effective use levosimendan in acute and advanced heart failure was examined in a series of expert tutorials. The proceedings of those tutorials are summarized in this review, with special reference to advanced heart failure and heart failure with concomitant renal dysfunction. Meta-analysis of clinical trials data is supportive of a renal-protective effect of levosimendan, while physiological observations suggest that this effect is exerted at least in part via organ-specific effects that may include selective vasodilation of glomerular afferent arterioles and increased renal blood flow, with no compromise of renal oxygenation. These lines of evidence require further investigation and their clinical significance needs to be evaluated in specifically designed prospective trials.
Subject: Inodilators
Acute heart failure
Advanced heart failure
Renal function
3121 General medicine, internal medicine and other clinical medicine
317 Pharmacy
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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