Efficacy and safety of intermittent, long-term, concomitant dobutamine and levosimendan infusions in severe heart failure refractory to dobutamine alone.
Thirty-six consecutive patients in New York Heart Association functional class IV, who were resistant to 24-hour continuous dobutamine infusion, were treated with continuous infusions of dobutamine 10 microg/kg/min for > or =48 hours (group I, n = 18), followed by weekly intermittent 8-hour infusions or more often if needed. In group II (n = 18), after the initial 24-hour infusion of dobutamine, a 24-hour levosimendan infusion was added followed by biweekly 24-hour infusions. The addition of intermittent levosimendan infusions prolonged the survival of patients with advanced heart failure refractory to intermittent dobutamine infusions (45-day survival rates were 6% and 61% in groups I and II, respectively; p = 0.0002, log-rank test).
Nanas
John N
JN
University of Athens School of Medicine, Department of Clinical Therapeutics, "Alexandra" Hospital, Athens, Greece. jnanas@ath.forthnet.gr
Papazoglou
Panagiotis
P
Tsagalou
Eleftheria P
EP
Ntalianis
Argirios
A
Tsolakis
Elias
E
Terrovitis
John V
JV
Kanakakis
John
J
Nanas
Seraphim N
SN
Alexopoulos
George P
GP
Anastasiou-Nana
Maria I
MI
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002908:Chronic Disease; D004280:Dobutamine / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005080:Exercise Test / Q000187:drug effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011724:Pyridazines / Q000008:administration & dosage* / Q000009:adverse effects; D015635:Radionuclide Ventriculography; D012306:Risk; D000077464:Simendan; D015996:Survival Rate
D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine