[Levosimendan in heart failure].
Clinical trials investigating traditional inotropic agents in patients with heart failure demonstrated an increased mortality rate (odds ratio 1.50; IC=0.51-3.92), high incidence of discontinuation of infusion therapy (odds ratio 0.46; IC=0.083-2.29) due to major side effects and, most of all, a limited clinical benefit (odds ratio 0.75; IC=1.42-0.08). On this background a new class of inotropic drugs, the calcium-sensitisers, have been developed. The safety and efficacy of levosimendan (Simdax) has been recently demonstrated in trials (LIDO e RUSSLAN) in patients with heart failure due to ischemic and not ischemic disease. Twenty-six patients with decompensated heart failure of different etiology have been treated with 24 hour infusion of levosimendan. In this experience the levosimendan improved the clinical status and the left ventricular ejection fraction.
Scelsi
Laura
L
Unità Cardiomiopatie, Scompenso cardiaco e Trapianto di Cuore, Divisione di Cardiologia, IRCCS Policlinico San Matteo, Pavia. emilio.corbellini@tin.it
Campana
Carlo
C
Ghio
Stefano
S
Monti
Lorenzo
L
Opasich
Cristina
C
De Feo
Stefania
S
Cobelli
Franco
F
Orlandi
Mario
M
Di Pasquale
Giuseppe
G
Tavazzi
Luigi
L
D002120:Calcium Channel Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D017202:Myocardial Ischemia / Q000150:complications; D011724:Pyridazines / Q000008:administration & dosage / Q000627:therapeutic use*; D000077464:Simendan; D013318:Stroke Volume / Q000187:drug effects; D016896:Treatment Outcome
D002120:Calcium Channel Agonists; D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan