Repetitive Dosing of Intravenous Levosimendan Improves Pulmonary Hemodynamics in Patients With Pulmonary Hypertension: Results of a Pilot Study

Kleber, Franz X.; Bollmann, Tom; Borst, Mathias M.; Costard‐Jäckle, Angelika; Ewert, Ralf; Kivikko, Matti; Petterson, Tiina; Pohjanjousi, Pasi; Sonntag, Sabine; Wikström, Gerhard

doi:10.1177/0091270008325150

Cited by 74 publications

(56 citation statements)

References 30 publications

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“…However, some research groups have obtained interesting results with limited duration of the infusion (i.e., 6 to 8 h), although pharmacokinetic information is limited. Of note, the reduction in pulmonary vascular resistance after a 6-hour infusion in patients with pulmonary hypertension does not seem to persist for 2 weeks as is seen with the 24-hour infusion [24].…”

Section: Levosimendanmentioning

confidence: 88%

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Pölzl¹,

Altenberger

Baholli

et al. 2017

International Journal of Cardiology

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Section: Levosimendanmentioning

confidence: 88%

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Pölzl¹,

Altenberger

Baholli

et al. 2017

International Journal of Cardiology

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“…Levosimendan decreases PVR and improves right-ventricular output in adult patients with right-ventricular failure secondary to several conditions, including PH. [259][260][261][262][263] The role of vasopressors is to increase systemic vascular resistance to augment right-ventricular output by increasing left-ventricular systolic pressure, and to maintain right coronary perfusion. Norepinephrine has been validated as a useful agent in several animal studies.…”

Section: Support Of Right-ventricular Functionmentioning

confidence: 99%

Advances in the Management of Pediatric Pulmonary Hypertension

2011

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Pulmonary hypertension is a rare disease in neonates, infants, and children, and is associated with substantial morbidity and mortality. An adequate understanding of the controlling pathophysiologic mechanisms is lacking. Moreover, a minority of research is focused specifically on neonatal and pediatric populations. Although therapeutic options have increased over the past several decades, they remain limited. In advanced pulmonary hypertension, progressive pulmonary vascular functional and structural changes ultimately cause increased pulmonary vascular impedance, rightventricular failure, and death. Management includes the prevention and/or treatment of active pulmonary vasoconstriction, the support of right-ventricle function, treatment of the underlying disease (if possible), and the promotion of regressive remodeling of structural pulmonary vascular changes. Most currently available therapies augment or inhibit factors, or mediators of their downstream signaling cascades, that originate in the pulmonary vascular endothelium. These pathways include nitric-oxide/cyclic guanosine monophosphate (cGMP), prostacyclin, and endothelin-1. The ability to reverse advanced structural changes remains an as yet unattained goal. This paper reviews the epidemiology, pathophysiology, current treatments, and emerging therapies related to neonatal and pediatric pulmonary hypertension.

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“…Digoxine, at a dose of 1 mg, may induce a small increase in cardiac output [16]. Levosimodan, a calcium sensitiser, increases cardiac output without increase in oxygen consumption and decreases pulmonary vascular resistance, and as such shows promise for the improvement of right ventriculo-arterial coupling [17,18]. Vasopressin, a weak nonadrenergic systemic vasopressor, may increase pulmonary vascular resistance at high doses and is, therefore, not recommended [19].…”

Section: Medical Emergenciesmentioning

confidence: 99%

Optimising the management of pulmonary arterial hypertension patients: emergency treatments

Delcroix¹,

Naeije²

2010

Eur Respir Rev

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Pulmonary arterial hypertension (PAH) is a rare and potentially fatal disease whose management is usually restricted to a few specialised centres. As patients do not necessarily live in the neighbourhood of these centres, daily care and emergencies have to be delegated to first and second lines. Treatment guidelines do not usually provide recommendations for acute emergency situations as evidence is scarce. This short review provides a description of our therapeutic protocols based on available data.A model of transmural organisation of care for PAH patients, currently applied in Belgium, is described. Thereafter, based on an analysis of the reasons of death in the PAH population, a review of the main emergencies is provided. Cardiac arrest and resuscitation, decompensated right heart failure, respiratory failure, arrhythmia, pericardial effusion, haemoptysis, surgery and drug-related adverse events will be discussed successively.Case reports showing the precariousness of PAH patients will enforce our thesis of the need for optimal patient management organisation.

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Repetitive Dosing of Intravenous Levosimendan Improves Pulmonary Hemodynamics in Patients With Pulmonary Hypertension: Results of a Pilot Study

Cited by 74 publications

References 30 publications

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy

Advances in the Management of Pediatric Pulmonary Hypertension

Optimising the management of pulmonary arterial hypertension patients: emergency treatments

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