Will ambulatory invasive hemodynamic monitoring benefit the management of Levosimendan in outpatients with advanced heart failure?

Silva, Doroteia

http://hdl.handle.net/10400.5/100609

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Authors

Silva, Doroteia

Abstract(s)

Levosimendan is an inotropic drug characterized by three mechanisms of action: positive inotropy, vasodilation, and cardioprotection. It is currently recommended in hospitalized patients with decompensated heart failure (HF), especially if there is evidence of low cardiac output (CO) and organ hypoperfusion, as a bridge to mechanical circulatory support or heart transplantation, or as a palliative therapy (class of recommendation IIb, level of evidence C). Intermittent long-term use of levosimendan pulses (repeated low doses) may be also considered in outpatients to improve functional class and quality of life (class IIb, level C). Randomized trials have generally failed to provide compelling evidence that inotropes improve survival in HF patients, although they are an essential part of HF therapy, improving symptoms and quality of life, and potentially reducing HF hospitalizations, all important endpoints in this scenario.