Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Mar;19(Suppl C):C8-C14.
doi: 10.1093/eurheartj/sux004. Epub 2017 Mar 8.

The inodilator levosimendan in repetitive doses in the treatment of advanced heart failure

Juan F Delgado  1 , Fabrizio Oliva  2 , Alexander Reinecke  3
Affiliations

The inodilator levosimendan in repetitive doses in the treatment of advanced heart failure

Juan F Delgado et al. Eur Heart J Suppl. 2017 Mar.

Abstract

Inotropes may be an appropriate response for some patients with advanced heart failure who remain highly symptomatic despite optimization of evidence-based therapy. These patients need to be supported waiting for a heart transplant or ventricular assist device, or may be candidates for inotropy as an intervention in its own right to maintain a patient in the best achievable circumstances. Objectives in such a situation include relieving symptoms, improving quality of life and reducing unplanned hospitalizations and the costs associated with such admissions. Levosimendan, a calcium sensitizer and potassium channel opener with inotrope and vasodilator actions, has emerged as a potentially valuable addition to the armamentarium in this context, used in repeated or intermittent cycles of therapy. Detailed proposals and guidance are offered for the identification of candidate patients with good prospects of a beneficial response to levosimendan, and for the safe and effective implementation of a course of therapy.

Keywords: Advanced heart failure; Intermittent; Levosimendan; Rehospitalization; Repetitive.

PubMed Disclaimer

Figures

Figure 1
Figure 1
How intermittent therapy with levosimendan fits into a larger strategy of treatment for patients with advanced heart failure. HTx, heart transplant; LVAD, left ventricular assist device; UF, ultrafiltration.
Figure 2
Figure 2
Protocol of the LION-HEART study.
Figure 3
Figure 3
Distribution of patients in Kiel (Germany) treated with levosimendan between 2009 and 2015. IMC, intermediate care unit; ICU, intensive care unit; HTx, heart transplant; LVAD, left ventricular assist device.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

  • Levosimendan in the light of the results of the recent randomized controlled trials: an expert opinion paper.
    Cholley B, Levy B, Fellahi JL, Longrois D, Amour J, Ouattara A, Mebazaa A. Cholley B, et al. Crit Care. 2019 Nov 29;23(1):385. doi: 10.1186/s13054-019-2674-4. Crit Care. 2019. PMID: 31783891 Free PMC article. Review.
  • Levosimendan Efficacy and Safety: 20 Years of SIMDAX in Clinical Use.
    Papp Z, Agostoni P, Alvarez J, Bettex D, Bouchez S, Brito D, Černý V, Comin-Colet J, Crespo-Leiro MG, Delgado JF, Édes I, Eremenko AA, Farmakis D, Fedele F, Fonseca C, Fruhwald S, Girardis M, Guarracino F, Harjola VP, Heringlake M, Herpain A, Heunks LMA, Husebye T, Ivancan V, Karason K, Kaul S, Kivikko M, Kubica J, Masip J, Matskeplishvili S, Mebazaa A, Nieminen MS, Oliva F, Papp JG, Parissis J, Parkhomenko A, Põder P, Pölzl G, Reinecke A, Ricksten SE, Riha H, Rudiger A, Sarapohja T, Schwinger RHG, Toller W, Tritapepe L, Tschöpe C, Wikström G, Lewinski DV, Vrtovec B, Pollesello P. Papp Z, et al. J Cardiovasc Pharmacol. 2020 Jul;76(1):4-22. doi: 10.1097/FJC.0000000000000859. J Cardiovasc Pharmacol. 2020. PMID: 32639325 Free PMC article. Review.
  • Levosimendan Efficacy and Safety: 20 years of SIMDAX in Clinical Use.
    Papp Z, Agostoni P, Alvarez J, Bettex D, Bouchez S, Brito D, Černý V, Comin-Colet J, Crespo-Leiro MG, Delgado JF, Édes I, Eremenko AA, Farmakis D, Fedele F, Fonseca C, Fruhwald S, Girardis M, Guarracino F, Harjola VP, Heringlake M, Herpain A, Heunks LM, Husebye T, Ivancan V, Karason K, Kaul S, Kivikko M, Kubica J, Masip J, Matskeplishvili S, Mebazaa A, Nieminen MS, Oliva F, Papp JG, Parissis J, Parkhomenko A, Põder P, Pölzl G, Reinecke A, Ricksten SE, Riha H, Rudiger A, Sarapohja T, Schwinger RH, Toller W, Tritapepe L, Tschöpe C, Wikström G, von Lewinski D, Vrtovec B, Pollesello P. Papp Z, et al. Card Fail Rev. 2020 Jul 8;6:e19. doi: 10.15420/cfr.2020.03. eCollection 2020 Mar. Card Fail Rev. 2020. PMID: 32714567 Free PMC article. Review.

References

    1. Metra M, Ponikowski P, Dickstein K, McMurray JJ, Gavazzi A, Bergh CH, Fraser AG, Jaarsma T, Pitsis A, Mohacsi P, Böhm M, Anker S, Dargie H, Brutsaert D, Komajda M.. Heart Failure Association of the European Society of Cardiology. Advanced chronic heart failure: a position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2007;9:684–694. - PubMed
    1. Desai AS. The three-phase terrain of heart failure readmissions. Circ Heart Fail 2012;5:398–400. - PubMed
    1. Desai AS, Stevenson LW.. Rehospitalization for heart failure: predict or prevent? Circulation 2012;126:501–506. - PubMed
    1. Chun S, Tu JV, Wijeysundera HC, Austin PC, Wang X, Levy D, Lee DS.. Lifetime analysis of hospitalizations and survival of patients newly admitted with heart failure. Circ Heart Fail 2012;5:414–421. - PMC - PubMed
    1. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ.. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733–742. - PubMed