title: Intermittent levosimendan infusions in advanced heart failure: a real world experience.
abstract: Objective To analyse the effects of levosimendan infusions in advanced heart failure. Methods Patients with advanced heart failure treated with repeated levosimendan infusions were retrospectively compared with controls. Clinical, blood and echocardiographic parameters were obtained at baseline and after 12 months, and before and after each levosimendan infusion. Hospitalizations for heart failure and in-hospital length of stay in the 6 months before enrolment and after 6 and 12 months were recorded, along with 1-year mortality. Results Twenty-five patients treated with levosimendan and 25 controls were studied. After each levosimendan infusion, ventricular function and various clinical and metabolic parameters were improved. After 12 months, left ventricular ejection fraction (LVEF) had improved compared with baseline in the levosimendan group. The 1-year mortality rate was similar in both groups. During the 6 months before enrolment, hospitalizations were fewer in controls compared with the levosimendan group; after 6 and 12 months they increased in controls and decreased in the levosimendan group. Seven patients were super-responders to levosimendan, with LVEF improving more than 20% and hospitalizations being reduced at 12 months compared with the rest of the levosimendan group. Conclusion Intermittent levosimendan improved LVEF and decreased hospitalizations in advanced heart failure and represents a therapeutic option for patients whose disease is worsening.
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Ortis
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Villani
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.|2 Department of Clinical Medicine, Prevention and Applied Biotechnology, University of Milano-Bicocca, Milan, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Oldani
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Giglio
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ciambellotti
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Facchini
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.|2 Department of Clinical Medicine, Prevention and Applied Biotechnology, University of Milano-Bicocca, Milan, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.affiliation: 1 Division of Cardiology, San Luca Hospital, Istituto Auxologico Italiano IRCCS, Milan, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Malfatto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D011724:Pyridazines / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077464:Simendan; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan
keywords: Advanced chronic heart failure; inotropic drugs; intermittent levosimendan