The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion

2.50
Hdl Handle:
http://hdl.handle.net/11287/610797
Title:
The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion
Authors:
Nieminen, M. S.; Buerke, M.; Cohen-Solál, A.; Costa, S.; Édes, I.; Erlikh, A.; Franco, F.; Gibson, Charles; Gorjup, V.; Guarracino, F.; Gustafsson, F.; Harjola, V-P; Husebye, T.; Karason, K.; Katsytadze, I.; Kaul, S.; Kivikko, M.; Marenzi, G.; Masip, J.; Matskeplishvili, S.; Mebazaa, A.; Møller, J. E.; Nessler, J.; Nessler, B.; Ntalianis, A.; Oliva, F.; Pichler-Cetin, E.; Põder, P.; Recio-Mayoral, A.; Rex, S.; Rokyta, R.; Strasser, R. H.; Zima, E.; Pollesello, P.
Abstract:
Acute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease. In acute heart failure, and especially in cardiogenic shock related to ischemic conditions, vasopressors and inotropes are used. However, both pathophysiological considerations and available clinical data suggest that these treatments may have disadvantageous effects. The inodilator levosimendan offers potential benefits due to a range of distinct effects including positive inotropy, restoration of ventriculo-arterial coupling, increases in tissue perfusion, and anti-stunning and anti-inflammatory effects. In clinical trials levosimendan improves symptoms, cardiac function, hemodynamics, and end-organ function. Adverse effects are generally less common than with other inotropic and vasoactive therapies, with the notable exception of hypotension. The decision to use levosimendan, in terms of timing and dosing, is influenced by the presence of pulmonary congestion, and blood pressure measurements. Levosimendan should be preferred over adrenergic inotropes as a first line therapy for all ACS-AHF patients who are under beta-blockade and/or when urinary output is insufficient after diuretics. Levosimendan can be used alone or in combination with other inotropic or vasopressor agents, but requires monitoring due to the risk of hypotension.
Citation:
The role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion 2016, 218:150 International Journal of Cardiology
Publisher:
Elsevier
Journal:
International Journal of Cardiology
Issue Date:
Sep-2016
URI:
http://hdl.handle.net/11287/610797
DOI:
10.1016/j.ijcard.2016.05.009
Additional Links:
http://linkinghub.elsevier.com/retrieve/pii/S0167527316309111
Note:
This article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text via the publisher's site.
Type:
Journal Article
Language:
en
ISSN:
01675273
Appears in Collections:
Cardiology; 2016 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorNieminen, M. S.en
dc.contributor.authorBuerke, M.en
dc.contributor.authorCohen-Solál, A.en
dc.contributor.authorCosta, S.en
dc.contributor.authorÉdes, I.en
dc.contributor.authorErlikh, A.en
dc.contributor.authorFranco, F.en
dc.contributor.authorGibson, Charlesen
dc.contributor.authorGorjup, V.en
dc.contributor.authorGuarracino, F.en
dc.contributor.authorGustafsson, F.en
dc.contributor.authorHarjola, V-Pen
dc.contributor.authorHusebye, T.en
dc.contributor.authorKarason, K.en
dc.contributor.authorKatsytadze, I.en
dc.contributor.authorKaul, S.en
dc.contributor.authorKivikko, M.en
dc.contributor.authorMarenzi, G.en
dc.contributor.authorMasip, J.en
dc.contributor.authorMatskeplishvili, S.en
dc.contributor.authorMebazaa, A.en
dc.contributor.authorMøller, J. E.en
dc.contributor.authorNessler, J.en
dc.contributor.authorNessler, B.en
dc.contributor.authorNtalianis, A.en
dc.contributor.authorOliva, F.en
dc.contributor.authorPichler-Cetin, E.en
dc.contributor.authorPõder, P.en
dc.contributor.authorRecio-Mayoral, A.en
dc.contributor.authorRex, S.en
dc.contributor.authorRokyta, R.en
dc.contributor.authorStrasser, R. H.en
dc.contributor.authorZima, E.en
dc.contributor.authorPollesello, P.en
dc.date.accessioned2016-05-26T12:30:32Z-
dc.date.available2016-05-26T12:30:32Z-
dc.date.issued2016-09-
dc.identifier.citationThe role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinion 2016, 218:150 International Journal of Cardiologyen
dc.identifier.issn01675273-
dc.identifier.doi10.1016/j.ijcard.2016.05.009-
dc.identifier.urihttp://hdl.handle.net/11287/610797-
dc.description.abstractAcute heart failure and/or cardiogenic shock are frequently triggered by ischemic coronary events. Yet, there is a paucity of randomized data on the management of patients with heart failure complicating acute coronary syndrome, as acute coronary syndrome and cardiogenic shock have frequently been defined as exclusion criteria in trials and registries. As a consequence, guideline recommendations are mostly driven by observational studies, even though these patients have a particularly poor prognosis compared to heart failure patients without signs of coronary artery disease. In acute heart failure, and especially in cardiogenic shock related to ischemic conditions, vasopressors and inotropes are used. However, both pathophysiological considerations and available clinical data suggest that these treatments may have disadvantageous effects. The inodilator levosimendan offers potential benefits due to a range of distinct effects including positive inotropy, restoration of ventriculo-arterial coupling, increases in tissue perfusion, and anti-stunning and anti-inflammatory effects. In clinical trials levosimendan improves symptoms, cardiac function, hemodynamics, and end-organ function. Adverse effects are generally less common than with other inotropic and vasoactive therapies, with the notable exception of hypotension. The decision to use levosimendan, in terms of timing and dosing, is influenced by the presence of pulmonary congestion, and blood pressure measurements. Levosimendan should be preferred over adrenergic inotropes as a first line therapy for all ACS-AHF patients who are under beta-blockade and/or when urinary output is insufficient after diuretics. Levosimendan can be used alone or in combination with other inotropic or vasopressor agents, but requires monitoring due to the risk of hypotension.en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0167527316309111en
dc.rightsArchived with thanks to International Journal of Cardiology. This is an Open Access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).en
dc.subjectWessex Classification Subject Headings::Cardiologyen
dc.titleThe role of levosimendan in acute heart failure complicating acute coronary syndrome: A review and expert consensus opinionen
dc.typeJournal Articleen
dc.identifier.journalInternational Journal of Cardiologyen
dc.description.noteThis article is freely available via Open Access. Click on the 'Additional Link' above to access the full-text via the publisher's site.en
dc.type.versionPublisheden
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