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Haemodynamic Balance in Acute and Advanced Heart Failure: An Expert Perspective on the Role of Levosimendan.

Journal article
Authors Pierguseppe Agostoni
Dimitrios T Farmakis
Jose M García-Pinila
Veli-Pekka Harjola
Kristjan Karason
Dirk von Lewinski
John Parissis
Piero Pollesello
Gerhard Pölzl
Alejandro Recio-Mayoral
Alexander Reinecke
Patrik Yerly
Endre Zima
Published in Cardiac failure review
Volume 5
Issue 3
Pages 155-161
ISSN 2057-7540
Publication year 2019
Published at Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 155-161
Language en
Links dx.doi.org/10.15420/cfr.2019.01.R1
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Acute heart failure, advanced heart failure, cardiorenal syndrome, inodilators, inotropes, levosimendan
Subject categories Cardiovascular medicine

Abstract

Acute and advanced heart failure are associated with substantial adverse short- and longer-term prognosis. Both conditions necessitate complex treatment choices to restore haemodynamic stability and organ perfusion, relieve congestion, improve symptoms and allow the patient to leave the hospital and achieve an adequate quality of life. Among the available intravenous vasoactive therapies, inotropes constitute an option when an increase in cardiac contractility is needed to reverse a low output state. Within the inotrope category, levosimendan is well suited to the needs of both sets of patients since, in contrast to conventional adrenergic inotropes, it has not been linked in clinical trials or wider clinical usage with increased mortality risk and retains its efficacy in the presence of beta-adrenergic receptor blockade; it is further believed to possess beneficial renal effects. The overall haemodynamic profile and clinical tolerability of levosimendan, combined with its extended duration of action, have encouraged its intermittent use in patients with advanced heart failure. This paper summarises the key messages derived from a series of 12 tutorials held at the Heart Failure 2019 congress organised in Athens, Greece, by the Heart Failure Association of the European Society of Cardiology.

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Utskriftsdatum: 2020-03-29