Newer treatments for decompensated heart failure: focus on levosimendan.

Drug Design, Development and Therapy
Ferenc Follath

Abstract

Acute heart failure (AHF) is a major cause of hospitalizations. Severe dyspnea, pulmonary congestion and low cardiac output with peripheral vasoconstriction and renal hypoperfusion is a main form of clinical presentation. Most patients with acute worsening have a pre-existing decompensated chronic heart failure (ADCHF), but AHF may also occur as a first manifestation of a previously unknown heart disease. Myocardial ischemia, cardiac arrhythmias, non-compliance with medication and infections are frequent precipitating factors. Management of AHF depends on the underlying heart disease and cause of decompensation. In patients with ADCHF vasodilators and iv diuretics are first-line drugs for rapid reduction of dyspnea and congestion. In patients with signs of low cardiac output and oliguria, inotropic agents are also often administered to prevent further deterioration. Beta-adrenergic agents and phosphodiesterase inhibitors correct the hemodynamic disturbance, but may also induce arrhythmias and worsen myocardial ischemia. Inotropic therapy therefore remains controversial. A novel class of drugs, the calcium sensitizers, represent a new therapeutic option. Levosimendan was shown to improve myocardial contractility without increasi...Continue Reading

References

Jan 1, 1994·European Journal of Clinical Pharmacology·J LillebergM S Nieminen
Sep 1, 1995·Journal of Molecular and Cellular Cardiology·H HaikalaI B Lindén
Nov 25, 2000·Journal of the American College of Cardiology·M S NieminenW J Remme
Dec 5, 2000·Clinical Pharmacology and Therapeutics·H UkkonenL M Voipio-Pulkki
Mar 28, 2002·JAMA : the Journal of the American Medical Association·UNKNOWN Publication Committee for the VMAC Investigators (Vasodilatation in the Management of Acute CHF)
Mar 28, 2002·JAMA : the Journal of the American Medical Association·Michael S CuffeUNKNOWN Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigato
Jul 23, 2002·Lancet·F FollathUNKNOWN Steering Committee and Investigators of the Levosimendan Infusion versus Dobutamine (LIDO) Study
Mar 23, 2005·Circulation·Jonathan D Sackner-BernsteinKeith D Aaronson
Apr 21, 2005·JAMA : the Journal of the American Medical Association·Jonathan D Sackner-BernsteinKeith Aaronson
Jun 1, 2005·European Journal of Heart Failure·Alain RudigerFerenc Follath
Apr 11, 2006·European Heart Journal·Luigi TavazziUNKNOWN Italian survey on Acute Heart Failure Investigators
May 23, 2006·European Journal of Heart Failure·Athanasios TrikasChristodoulos Stefanadis
Sep 27, 2006·European Heart Journal·Markku S NieminenUNKNOWN Heart Failure Association, European Society of Cardiology
Nov 28, 2006·European Heart Journal·Krista Siirilä-WarisUNKNOWN FINN-AKVA Study Group
Mar 3, 2007·Clinical Pharmacokinetics·Jaakko PuttonenPertti J Pentikäinen
May 3, 2007·JAMA : the Journal of the American Medical Association·Alexandre MebazaaUNKNOWN SURVIVE Investigators
Nov 1, 2007·QJM : Monthly Journal of the Association of Physicians·S AroraA Gradman
Feb 15, 2008·Critical Care Medicine·John W Petersen, G Michael Felker
Feb 28, 2008·Journal of Clinical Pharmacology·Jaakko PuttonenPertti J Pentikäinen

❮ Previous
Next ❯

Citations

Mar 8, 2011·Intensive Care Medicine·Karen Stuart-Smith
Aug 30, 2012·Scandinavian Cardiovascular Journal : SCJ·Matti KivikkoAlexandre Mebazaa
Jun 23, 2011·European Journal of Pharmacology·Sotirios KakavasTheodoros Xanthos
May 7, 2013·Journal of Zhejiang University. Science. B·Xuan HuangYi-hui Zhi
Apr 22, 2015·Revista brasileira de anestesiologia·Fabiola Quinteros HinojosaFernando Gilsanz
Sep 22, 2011·Expert Review of Cardiovascular Therapy·Michael J BoniosJohn N Nanas
Jun 21, 2016·Canadian Journal of Physiology and Pharmacology·Péter NánásiZoltán Papp

❮ Previous
Next ❯

Software Mentioned

ADCHF

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.