title: [Therapy of acute decompensated heart failure with levosimendan].
abstract: OBJECTIVE
  To determine the short-term hemodynamic and clinical effects of levosimendan, a calcium-sensitizing agent, in patients with decompensated heart failure.
  
  
  METHODS
  Seven patients with cardiogenic shock requiring catecholamines (two patients with acute myocardial infarction, two patients with decompensated hypertensive heart disease, one patient with low cardiac output with ischemic cardiomyopathy, two patients with dilated cardiomyopathy [ethyl-toxic, polymyositis] with a cardiac index < or = 2.5 ) 1 x min(-1) x m(-2) and a pulmonary wedge pressure > or = 15 mmHg received levosimendan with an initial loading dose of 12 microg/kg over 10 min followed by a continuous infusion of 0.1 microg/kg/min for 24 h.
  
  
  RESULTS
  During levosimendan infusion an increase in cardiac index (30% after 6 h and 24 h), a decrease in heart rate (4% after 6 h and 10% after 24 h, respectively), and a decrease in systemic vascular resistance (27% after 6 h and 41% after 24 h, respectively) appeared. In combination with volume resuscitation the pulmonary capillary wedge pressure increased. Under therapy with levosimendan no relevant adverse events occurred; there was no increase in severe cardiac arrhythmias and QT interval duration.
  
  
  CONCLUSIONS
  Levosimendan causes rapid improvement in hemodynamic function in patients with cardiogenic shock. These hemodynamic effects are not associated with relevant adverse events. Levosimendan may be of value in the short-term management of patients with cardiogenic shock.
authors.affiliation: Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf. Katrin.Mueller@med.uni-duesseldorf.de
authors.forename: Karin
authors.initials: K
authors.lastname: Müller
authors.forename: Ansgar
authors.initials: A
authors.lastname: Peters
authors.forename: Tobias
authors.initials: T
authors.lastname: Zeus
authors.forename: Markus
authors.initials: M
authors.lastname: Hennersdorf
authors.forename: Bodo Eckehard
authors.initials: BE
authors.lastname: Strauer
mesh_terms: D000328:Adult; D000368:Aged; D002120:Calcium Channel Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016292:Procedural Sedation; D003422:Critical Care; D004280:Dobutamine / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000008:administration & dosage / Q000009:adverse effects; D011724:Pyridazines / Q000008:administration & dosage* / Q000009:adverse effects; D012770:Shock, Cardiogenic / Q000188:drug therapy*; D000077464:Simendan
chemical_list: D002120:Calcium Channel Agonists; D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine; D009638:Norepinephrine