title: Efficiency and safety of prolonged levosimendan infusion in patients with acute heart failure.
abstract: Background. Levosimendan is an inotropic drug with unique pharmacological advantages in patients with acute heart failure. Scope of this study is to determine whether longer infusion patterns without the hypotension-inducing loading dose could justify an effective and safe alternative approach. Methods. 70 patients admitted to the emergencies with decompensated chronic heart failure received intravenously levosimendan without a loading dose up to 72 hours. Clinical parameters, BNP (Brain Natriuretic Peptide) and signal-averaged-ECG data (SAECG) were recorded up to 72 hours. Results. The 48-hour group demonstrated a statistically significant BNP decrease (P < .001) after 48 hours, which also maintained after 72 hours. The 72-hour group demonstrated a bordeline decrease of BNP after 48 hours (P = .039), necessitating an additional 24-hour infusion to achieve significant reduction after 72 hours (P < .004). SAECG data demonstrated a statistically significant decrease after 72 hours (P < .04). Apart from two deaths due to advanced heart failure, no major complications were observed. Conclusion. Prolonged infusion of levosimendan without a loading dose is associated with an acceptable clinical and neurohumoral response.
authors.affiliation: Department of Cardiology, West German Heart Center, Medical School, University of Duisburg-Essen, 45122 Essen, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Aidonidis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kanonidis
authors.forename: Vasileios
authors.initials: V
authors.lastname: Koutsimanis
authors.forename: Till
authors.initials: T
authors.lastname: Neumann
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Georgios
authors.initials: G
authors.lastname: Sakadamis