Levosimendan is not effective in reducing pulmonary pressures in patients with idiopathic pulmonary arterial hypertension: report of two cases.
Currently, prostacyclin, endothelin receptor antagonists and phosphodiesterase inhibitors are recommended therapy in idiopathic pulmonary arterial hypertension. However, each of these drugs has limited efficacy in the improvement of clinical symptoms, pulmonary hemodynamics and long-term survival. Levosimendan, a novel calcium-sensitizing inodilator agent, has been shown to have pulmonary vasodilatory action. However, the potential pulmonary vasodilating effect of levosimendan in patients with idiopathic pulmonary arterial hypertension remains unclear. Levosimendan administered in two patients with nonvasoreactive idiopathic pulmonary arterial hypertension exhibited deterioration in clinical status, and, contrary to what was expected, levosimendan was found to increase pulmonary pressures and did not lead to a substantial improvement of the patient's condition.
Department of Cardiology, Eskisehir Osmangazi University, Eskisehir, Turkey. yukselc@ogu.edu.tr
Yuksel
Y
Cavusoglu
Ayse
A
Beyaztas
Alparslan
A
Birdane
Necmi
N
Ata
D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D006801:Humans; D006835:Hydrazones / Q000009:adverse effects / Q000627:therapeutic use*; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000187:drug effects* / Q000503:physiopathology; D011724:Pyridazines / Q000009:adverse effects / Q000627:therapeutic use*; D000077464:Simendan; D017211:Treatment Failure; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use*
D000959:Antihypertensive Agents; D006835:Hydrazones; D011724:Pyridazines; D014665:Vasodilator Agents; D000077464:Simendan