TY - JOUR
T1 - Levosimendan beyond inotropy and acute heart failure
T2 - Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper
AU - Farmakis, Dimitrios
AU - Alvarez, Julian
AU - Gal, Tuvia Ben
AU - Brito, Dulce
AU - Fedele, Francesco
AU - Fonseca, Candida
AU - Gordon, Anthony C.
AU - Gotsman, Israel
AU - Grossini, Elena
AU - Guarracino, Fabio
AU - Harjola, Veli Pekka
AU - Hellman, Yaron
AU - Heunks, Leo
AU - Ivancan, Visnja
AU - Karavidas, Apostolos
AU - Kivikko, Matti
AU - Lomivorotov, Vladimir
AU - Longrois, Dan
AU - Masip, Josep
AU - Metra, Marco
AU - Morelli, Andrea
AU - Nikolaou, Maria
AU - Papp, Zoltán
AU - Parkhomenko, Alexander
AU - Poelzl, Gerhard
AU - Pollesello, Piero
AU - Ravn, Hanne Berg
AU - Rex, Steffen
AU - Riha, Hynek
AU - Ricksten, Sven Erik
AU - Schwinger, Robert H.G.
AU - Vrtovec, Bojan
AU - Yilmaz, M. Birhan
AU - Zielinska, Marzenna
AU - Parissis, John
N1 - Publisher Copyright:
© 2016 The Authors
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence. The present position paper, derived by a panel of 35 experts in the field of cardiology, cardiac anesthesiology, intensive care medicine, cardiac physiology, and cardiovascular pharmacology from 22 European countries, compiles the existing evidence on the pleiotropic effects of levosimendan, identifies potential novel areas of clinical application and defines the corresponding gaps in evidence and the required research efforts to address those gaps.
AB - Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence. The present position paper, derived by a panel of 35 experts in the field of cardiology, cardiac anesthesiology, intensive care medicine, cardiac physiology, and cardiovascular pharmacology from 22 European countries, compiles the existing evidence on the pleiotropic effects of levosimendan, identifies potential novel areas of clinical application and defines the corresponding gaps in evidence and the required research efforts to address those gaps.
KW - Cardiogenic shock
KW - Cardioprotection
KW - Heart failure
KW - Inotropes
KW - Levosimendan
KW - Organ protection
UR - http://www.scopus.com/inward/record.url?scp=84980320215&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2016.07.202
DO - 10.1016/j.ijcard.2016.07.202
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C2 - 27498374
AN - SCOPUS:84980320215
SN - 0167-5273
VL - 222
SP - 303
EP - 312
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -
