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Repetitive use of levosimendan for treatment of chronic advanced heart failure: clinical evidence, practical considerations, and perspectives: an expert panel consensus
MS. Nieminen, J. Altenberger, T. Ben-Gal, A. Böhmer, J. Comin-Colet, K. Dickstein, I. Edes, F. Fedele, C. Fonseca, MJ. García-González, G. Giannakoulas, Z. Iakobishvili, P. Jääskeläinen, A. Karavidas, J. Kettner, M. Kivikko, LH. Lund, ST....
Jazyk angličtina Země Nizozemsko
Typ dokumentu konsensus - konference, časopisecké články
- MeSH
- chronická nemoc MeSH
- hydrazony aplikace a dávkování MeSH
- lidé MeSH
- pyridaziny aplikace a dávkování MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- srdeční selhání farmakoterapie MeSH
- stupeň závažnosti nemoci MeSH
- vazodilatancia aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- konsensus - konference MeSH
BACKGROUND: The intravenous inodilator levosimendan was developed for the treatment of patients with acutely decompensated heart failure. In the last decade scientific and clinical interest has arisen for its repetitive or intermittent use in patients with advanced chronic, but not necessarily acutely decompensated, heart failure. Recent studies have suggested long-lasting favourable effects of levosimendan when administered repetitively, in terms of haemodynamic parameters, neurohormonal and inflammatory markers, and clinical outcomes. The existing data, however, requires further exploration to allow for definitive conclusions on the safety and clinical efficacy of repetitive use of levosimendan. METHODS AND RESULTS: A panel of 30 experts from 15 countries convened to review and discuss the existing data, and agreed on the patient groups that can be considered to potentially benefit from intermittent treatment with levosimendan. The panel gave recommendations regarding patient dosing and monitoring, derived from the available evidence and from clinical experience. CONCLUSIONS: The current data suggest that in selected patients and support out-of-hospital care, intermittent/repetitive levosimendan can be used in advanced heart failure to maintain patient stability. Further studies are needed to focus on morbidity and mortality outcomes, dosing intervals, and patient monitoring. Recommendations for the design of further clinical studies are made.
2nd Cardiology Department and Heart Failure Unit Attikon Teaching Hospital Athens Greece
Cardiology Clinic of the Gennimatas General Hospital of Athens Athens Greece
Cardiology Department AHEPA University Hospital Thessaloniki Greece
Cardiology Department of Experimental and Applied Medicine University of Brescia Brescia Italy
Cardiology Institute of Medical Sciences Uppsala University Uppsala Sweden
Clinical Department of Cardiology University Clinical Centre Ljubljana Ljubljana Slovenia
Department of Internal Medicine 3 University of Innsbruck Austria
Heart Center Kuopio University Hospital Kuopio Finland
Heart Failure Program Cardiology Department Hospital del Mar Barcelona Spain
Heart Failure Unit and Heart Transplant Clinic Rabin Medical Center Petah Tikva Israel
Helsinki University Hospital Helsinki Finland
Institute of Cardiology Medical and Health Center University of Debrecen Debrecen Hungary
LK Krems Abteilung für Innere Medizin mit kardiologischem Schwerpunkt Krems Austria
Scientific Centre of Cardiovascular Surgery of Bakulev Moscow Russia
Stavanger University Hospital University of Bergen Stavanger Norway
Strazhesko Institute of Cardiology National Scientific Centre Kiev Ukraine
Unfallkrankenhaus Berlin Klinik für Innere Medizin Berlin Germany
Unit of Cardiology Department of Medicine Karolinska Institutet Stockholm Sweden
Citace poskytuje Crossref.org
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- $a Nieminen, M S $u Helsinki University Hospital, Helsinki, Finland. Electronic address: markku.nieminen@hus.fi.
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- $a Repetitive use of levosimendan for treatment of chronic advanced heart failure: clinical evidence, practical considerations, and perspectives: an expert panel consensus / $c MS. Nieminen, J. Altenberger, T. Ben-Gal, A. Böhmer, J. Comin-Colet, K. Dickstein, I. Edes, F. Fedele, C. Fonseca, MJ. García-González, G. Giannakoulas, Z. Iakobishvili, P. Jääskeläinen, A. Karavidas, J. Kettner, M. Kivikko, LH. Lund, ST. Matskeplishvili, M. Metra, F. Morandi, F. Oliva, A. Parkhomenko, J. Parissis, P. Pollesello, G. Pölzl, RH. Schwinger, J. Segovia, M. Seidel, B. Vrtovec, G. Wikström,
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- $a BACKGROUND: The intravenous inodilator levosimendan was developed for the treatment of patients with acutely decompensated heart failure. In the last decade scientific and clinical interest has arisen for its repetitive or intermittent use in patients with advanced chronic, but not necessarily acutely decompensated, heart failure. Recent studies have suggested long-lasting favourable effects of levosimendan when administered repetitively, in terms of haemodynamic parameters, neurohormonal and inflammatory markers, and clinical outcomes. The existing data, however, requires further exploration to allow for definitive conclusions on the safety and clinical efficacy of repetitive use of levosimendan. METHODS AND RESULTS: A panel of 30 experts from 15 countries convened to review and discuss the existing data, and agreed on the patient groups that can be considered to potentially benefit from intermittent treatment with levosimendan. The panel gave recommendations regarding patient dosing and monitoring, derived from the available evidence and from clinical experience. CONCLUSIONS: The current data suggest that in selected patients and support out-of-hospital care, intermittent/repetitive levosimendan can be used in advanced heart failure to maintain patient stability. Further studies are needed to focus on morbidity and mortality outcomes, dosing intervals, and patient monitoring. Recommendations for the design of further clinical studies are made.
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