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Levosimendan in Outpatients with Advanced Heart Failure: Single-Center Experience of 200 Intermittent Perfusions

2023-04Journal article Open access
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dc.contributor.authorFerreira Reis, J
dc.contributor.authorGonçalves, A
dc.contributor.authorIlhão Moreira, R
dc.contributor.authorPereira-da-Silva, T
dc.contributor.authorTimóteo, AT
dc.contributor.authorPombo, D
dc.contributor.authorCarvalho, T
dc.contributor.authorCorreia, C
dc.contributor.authorSantos, C
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2023-05-24T15:00:25Z
dc.date.available2023-05-24T15:00:25Z
dc.date.issued2023-04
dc.description.abstractIntroduction: Patients with advanced heart failure (HF) have high morbidity and mortality, with only a small proportion being eligible for advanced therapies. Intermittent outpatient levosimendan infusion has been shown to provide symptomatic relief and reduce the rate of HF events. Our aim was to assess the safety and efficacy of outpatient levosimendan administration in an advanced HF population. Methods: This is a report of a single-center experience of consecutive advanced HF patients referred for intermittent intravenous outpatient administration of levosimendan, between January 2018 and March 2021. Baseline and follow-up evaluation included clinical assessment, laboratory tests, transthoracic echocardiography and cardiopulmonary exercise testing. Baseline and clinical follow-up data were compared using the Wilcoxon signed-rank test. Results: A total of 24 patients (60.8 years, 83% male, mean left ventricular ejection fraction [LVEF] 24%), with a median of 1.5 HF hospitalizations in the previous six months, were referred for outpatient levosimendan pulses, the majority as a bridge to transplantation or due to clinical deterioration. At six-month follow-up there was a significant reduction in HF hospitalizations to 0.4±0.7 (p<0.001). NYHA class IV (52.2% to 12.5%, p=0.025) and NT-proBNP (8812.5 to 3807.4 pg/ml, p=0.038) were also significantly reduced. Exercise capacity was significantly improved, including peak oxygen uptake (p=0.043) and VE/VCO2 slope (p=0.040). LVEF improved from 24.0% to 29.7% (p=0.008). No serious adverse events were reported. Conclusion: Repeated levosimendan administration in advanced HF patients is a safe procedure and was associated with a reduction in HF hospitalizations, functional and LVEF improvement, and reduction in NT-proBNP levels during follow-up.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol . 2023 Apr;42(4):335-343.pt_PT
dc.identifier.doi10.1016/j.repc.2022.03.006pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4535
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectHSM CARpt_PT
dc.subjectHumanspt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectCardiotonic Agents / therapeutic usept_PT
dc.subjectHeart Failure* / therapypt_PT
dc.subjectHydrazones / therapeutic usept_PT
dc.subjectOutpatientspt_PT
dc.subjectPyridazines* / therapeutic usept_PT
dc.subjectSimendan / pharmacologypt_PT
dc.subjectSimendan / therapeutic usept_PT
dc.subjectStroke Volumept_PT
dc.subjectVentricular Function, Leftpt_PT
dc.titleLevosimendan in Outpatients with Advanced Heart Failure: Single-Center Experience of 200 Intermittent Perfusionspt_PT
dc.title.alternativeAdministração Intermitente de Levosimendan em Hospital de Dia de Insuficiência Cardíaca: Experiência Unicêntrica de 200 Tratamentospt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage343pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage335pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume42pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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