Publication details

Léčba levosimendanem: up-date 2012

Title in English The use of levosimendan: up-date 2012
Authors

PAŘENICA Jiří MIKLÍK Roman PAVLUŠOVÁ Marie ŠPINAR Jindřich

Year of publication 2012
Type Article in Periodical
Magazine / Source Kardiologická revue
MU Faculty or unit

Faculty of Medicine

Citation
Field Cardiovascular diseases incl. cardiosurgery
Keywords levosimendan; acute heart failure
Description Calcium senzitizer levosimendan is a drug with positive inotropic, vasodilating and cardioprotective effect. Its effect on an increase of cardiac output and decrease of pulmonary wedge pressure in acute heart failure patients has been repeatedly confirmed. When compared to dobutamine, levosimendan increased glomerular filtration rate. Despite the fact that clinical trials have failed to prove its impact on mortality of the patients, a meta-analysis of 45 randomized controlled studies has demonstrated a potential survival benefit of levosimendan application, both when compared to placebo and dobutamine. According to current recommendations, positively inotropic agents should be administered only in patients with severe heart failure with prolonged/no response to intravenous diuretics and vasodilators provided that the major cause of heart failure is the low cardiac output with/without hypotension. The use of levosimendan, eventuelly phosphodiesterasis III inhibitors, should be preffered prior to administration of dobutamine in patients chronically treated with betablockers, including those presenting with acute coronary syndrom.

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