TY - JOUR
T1 - Haemodynamic Balance in Acute and Advanced Heart Failure
T2 - An Expert Perspective on the Role of Levosimendan
AU - Agostoni, Piergiuseppe
AU - Farmakis, Dimitrios T
AU - García-Pinilla, Jose M
AU - Harjola, Veli-Pekka
AU - Karason, Kristjan
AU - von Lewinski, Dirk
AU - Parissis, John
AU - Pollesello, Piero
AU - Pölzl, Gerhard
AU - Recio-Mayoral, Alejandro
AU - Reinecke, Alexander
AU - Yerly, Patrik
AU - Zima, Endre
N1 - Copyright © 2019, Radcliffe Cardiology.
PY - 2019/11
Y1 - 2019/11
N2 - Acute and advanced heart failure are associated with substantial adverse short- and longer-term prognosis. Both conditions necessitate complex treatment choices to restore haemodynamic stability and organ perfusion, relieve congestion, improve symptoms and allow the patient to leave the hospital and achieve an adequate quality of life. Among the available intravenous vasoactive therapies, inotropes constitute an option when an increase in cardiac contractility is needed to reverse a low output state. Within the inotrope category, levosimendan is well suited to the needs of both sets of patients since, in contrast to conventional adrenergic inotropes, it has not been linked in clinical trials or wider clinical usage with increased mortality risk and retains its efficacy in the presence of beta-adrenergic receptor blockade; it is further believed to possess beneficial renal effects. The overall haemodynamic profile and clinical tolerability of levosimendan, combined with its extended duration of action, have encouraged its intermittent use in patients with advanced heart failure. This paper summarises the key messages derived from a series of 12 tutorials held at the Heart Failure 2019 congress organised in Athens, Greece, by the Heart Failure Association of the European Society of Cardiology.
AB - Acute and advanced heart failure are associated with substantial adverse short- and longer-term prognosis. Both conditions necessitate complex treatment choices to restore haemodynamic stability and organ perfusion, relieve congestion, improve symptoms and allow the patient to leave the hospital and achieve an adequate quality of life. Among the available intravenous vasoactive therapies, inotropes constitute an option when an increase in cardiac contractility is needed to reverse a low output state. Within the inotrope category, levosimendan is well suited to the needs of both sets of patients since, in contrast to conventional adrenergic inotropes, it has not been linked in clinical trials or wider clinical usage with increased mortality risk and retains its efficacy in the presence of beta-adrenergic receptor blockade; it is further believed to possess beneficial renal effects. The overall haemodynamic profile and clinical tolerability of levosimendan, combined with its extended duration of action, have encouraged its intermittent use in patients with advanced heart failure. This paper summarises the key messages derived from a series of 12 tutorials held at the Heart Failure 2019 congress organised in Athens, Greece, by the Heart Failure Association of the European Society of Cardiology.
U2 - 10.15420/cfr.2019.01.R1
DO - 10.15420/cfr.2019.01.R1
M3 - Review article
C2 - 31768272
VL - 5
SP - 155
EP - 161
JO - Cardiac Failure Review
JF - Cardiac Failure Review
SN - 2057-7540
IS - 3
ER -