Levosimendan in Acute Pulmonary Embolism

Bp, Powell; D, Simes

doi:10.1177/0310057x0703500518

Cited by 8 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…reported a case with a 72 year old man suffering from life-threating acute pulmonary embolism. 52 Due to a history of upper gastrointestinal bleeding and a poor pre-morbid status, medical, invasive, and surgical treatments were unfavorable. The patient received a 24 h levosimendan infusion that, after transient hypotension and tachycardia, improved the patient with hemodynamic stabilization, increasing P a O 2 , and improvement in metabolic parameters.…”

Section: Levosimendan In Phmentioning

confidence: 99%

“…In acute and chronic pulmonary thromboembolism, only two case reports have been published. Powell et al reported a case with a 72 year old man suffering from life‐threating acute pulmonary embolism 52 . Due to a history of upper gastrointestinal bleeding and a poor pre‐morbid status, medical, invasive, and surgical treatments were unfavorable.…”

Section: Levosimendan In Phmentioning

confidence: 99%

See 1 more Smart Citation

Levosimendan in pulmonary hypertension and right heart failure

Hansen¹,

Andersen²,

Nielsen‐Kudsk³

2018

Pulm. circ.

View full text Add to dashboard Cite

Pulmonary hypertension is a multifactorial disease with a high morbidity and mortality. Right ventricular function is the most important predictor of morbidity and mortality in patients suffering from pulmonary hypertension, but currently there are no approved treatments directly supporting the failing right ventricle. Levosimendan is a calcium sensitizing agent with inotropic, pulmonary vasodilatory, and cardioprotective properties. Given its pharmacodynamic profile, levosimendan could be a potential novel agent for the treatment of right ventricular failure caused by pulmonary hypertension. The aim of this review is to provide an overview of the current knowledge on the effects of levosimendan in pulmonary hypertension and right heart failure.

show abstract

Section: Levosimendan In Phmentioning

confidence: 99%

Section: Levosimendan In Phmentioning

confidence: 99%

Levosimendan in pulmonary hypertension and right heart failure

Hansen¹,

Andersen²,

Nielsen‐Kudsk³

2018

Pulm. circ.

View full text Add to dashboard Cite

show abstract

“…Only very few levosimendan studies have been conducted in PH associated with lung disease and in PH related to pulmonary thromboembolism, and results are not comparable [53][54][55].…”

Section: Levosimendan In Pulmonary Hypertensionmentioning

confidence: 99%

Levosimendan: What Have We Learned So Far?

Villa

Tavazzi

Guarracino

et al. 2019

Curr Anesthesiol Rep

View full text Add to dashboard Cite

Purpose of Review Vasoactive therapy represents a pivotal yet debated topic in critically ill patients and in those with chronic heart failure. Levosimendan, a calcium sensitizer agent with inodilating properties, has been in the market for 27 years and new indications came out over time. The aim of the present review is to highlight what is actually proven and what is debated on the use of levosimendan in light of its pharmacologic features and the pathophysiological evidence. Recent Findings Levosimendan was firstly seen as an inodilator acting through calcium sensitization in myocytes both in the myocardium and in vascular smooth muscle. Over the years, its anti-inflammatory properties became clearer and a role in preconditioning and weaning from mechanical circulatory support was postulated. More recently, a possible action on other muscular fibers, namely, diaphragmatic myocytes, was observed, leading to a possible application in mechanical ventilationrelated diaphragmatic dysfunction. Summary Preliminary data showed promising effects of levosimendan in patients with sepsis-related and stress-related (Takotsubo) myocardial dysfunction, in those difficult-to-wean from mechanical circulatory support and in ventilatorassociated diaphragmatic dysfunction. Moreover, its vasodilating, anti-oxidant, and neuroendocrine properties pave the way to a number of additional possible applications. Larger studies yielding to more conclusive results on these indications are under way or need to be planned in the future.

show abstract

“…Clinically available inodilators include levosimendan, milrinone, and dobutamine, all of which have different hemodynamic profiles 3 – 6 . Inodilators are used in acute cardiac care and in chronic pulmonary hypertension (PH), 3 , 7 but only case reports or small case series exist on their effect in acute PE 8 , 9 . At present, dobutamine has received a Class IIa recommendation limited to high‐risk PE patients, whereas neither levosimendan nor milrinone is mentioned in the European Society of Cardiology Pulmonary Embolism guidelines 1 …”

Section: Introductionmentioning

confidence: 99%

Levosimendan, milrinone, and dobutamine in experimental acute pulmonary embolism

Lyhne

Dragsbæk

Hansen³

et al. 2021

Pulm. circ.

View full text Add to dashboard Cite

Acute pulmonary embolism (PE) is a frequent condition in emergency medicine and potentially fatal. Cause of death is right ventricular (RV) failure due to increased RV afterload from both pulmonary vascular obstruction and vasoconstriction. Inodilators are interesting drugs of choice as they may improve RV function and lower its afterload. We aimed to investigate the cardiovascular effects of three clinically relevant inodilators: levosimendan, milrinone and dobutamine in acute PE. We conducted a randomized, blinded, animal study using 18 female pigs. Animals received large autologous PE until doubling of baseline mean pulmonary arterial pressure and were randomized to increasing doses of each inodilator. Effects were evaluated with bi-ventricular pressure-volume loop recordings, right heart catheterization and blood gas analyses. Induction of PE increased RV afterload and pulmonary pressure (p<0.05) causing RV dysfunction. Levosimendan and milrinone showed beneficial hemodynamic profiles by lowering RV pressures and volume (p<0.001) and improved RV function and cardiac output (p<0.05) without increasing RV mechanical work. Dobutamine increased RV pressure and function (p<0.01) but at a cost of increased mechanical work at the highest doses, showing an adverse hemodynamic profile. In a porcine model of acute PE, levosimendan and milrinone reduced RV afterload and improved RV function, whereas dobutamine at higher doses increased RV afterload and RV mechanical work. The study motivates clinical testing of inodilators in patients with acute PE and RV dysfunction.

show abstract

Levosimendan in Acute Pulmonary Embolism

Cited by 8 publications

References 10 publications

Levosimendan in pulmonary hypertension and right heart failure

Levosimendan in pulmonary hypertension and right heart failure

Levosimendan: What Have We Learned So Far?

Levosimendan, milrinone, and dobutamine in experimental acute pulmonary embolism

Contact Info

Product

Resources

About