The use of levosimendan: up-date 2012

Authors: J. Pařenica;  R. Miklík;  M. Pavlušová;  J. Špinar
Published in: Kardiol Rev Int Med 2012, 14(3): 191-193


Calcium senzitizer levosimendan is a drug with positive inotropic, vasodilating and cardioprotective effect. Its effect on an increase of cardiac output and decrease of pulmonary wedge pressure in acute heart failure patients has been repeatedly confirmed. When compared to dobutamine, levosimendan increased glomerular filtration rate. Despite the fact that clinical trials have failed to prove its impact on mortality of the patients, a meta-analysis of 45 randomized controlled studies has demonstrated a potential survival benefit of levosimendan application, both when compared to placebo and dobutamine. According to current recommendations, positively inotropic agents should be administered only in patients with severe heart failure with prolonged/no response to intravenous diuretics and vasodilators provided that the major cause of heart failure is the low cardiac output with/without hypotension. The use of levosimendan, eventuelly phosphodiesterasis III inhibitors, should be preffered prior to administration of dobutamine in patients chronically treated with betablockers, including those presenting with acute coronary syndrom.

levosimendan – acute heart failure


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Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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