Hemodynamic effects of levosimendan added to dobutamine in patients with decompensated advanced heart failure refractory to dobutamine alone

• Published in: The American journal of cardiology Vol. 94; no. 10; pp. 1329 - 1332
• Main Authors: Nanas, John N., Papazoglou, Panagiotis P., Terrovitis, John V., Kanakakis, John, Dalianis, Argirios, Tsolakis, Elias, Tsagalou, Eleftheria P., Agrios, Nikolaos, Christodoulou, Kostantinos, Anastasiou-Nana, Maria I.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.11.2004; Elsevier; Elsevier Limited
• Subjects: Administration, Oral; Biological and medical sciences; Cardiac Output - drug effects; Cardiology. Vascular system; Cardiotonic Agents - administration & dosage; Diuretics - administration & dosage; Dobutamine - administration & dosage; Drug therapy; Drug Therapy, Combination; Female; Furosemide - administration & dosage; Heart; Heart failure; Heart Failure - drug therapy; Heart Failure - physiopathology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Hemodynamics - drug effects; Humans; Hydrazones - administration & dosage; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Pulmonary Wedge Pressure - drug effects; Pyridazines - administration & dosage; Human; Heart failure; Refractory; Levosimendan; Heart disease; Dobutamine; Cardiovascular disease; Hemodynamics
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2004.07.128

A 24-hour infusion of levosimendan was added to dobutamine in 18 patients (aged 63 ± 9 years) hospitalized for management of decompensated New York Heart Association functional class IV heart failure refractory to a continuous 24-hour infusion of dobutamine (10 μg/kg/min) and furosemide (10 mg/hour); the primary study end point was a ≥40% increase in cardiac index and a ≥25% decrease in pulmonary capillary wedge pressure compared with pretreatment measurements.The primary end point was reached in one of the patients treated with dobutamine alone versus 7 patients (39%) treated with levosimendan and dobutamine combined (p = 0.008), whereas at 24 hours, the combined treatment was associated with a 0.76 ± 0.78 L/min/m 2 (p = 0.001) mean increase in cardiac index and a 6.4 ± 7.3 mm Hg (p = 0.002) mean decrease in pulmonary capillary wedge pressure compared with measurements obtained after 24 hours of dobutamine infusion alone. Symptoms were alleviated in all patients, and all but 3 were discharged from the hospital.