[Levosimendan in patients with acute cardiac failure]

To assess levosimendan efficacy in acute cardiac failure.

We included 25 patients with acute cardiac failure and partial conventional therapy response defined as persistence of low cardiac output with inotropic support. We started levosimendan at loading dose and continuous infusion for 24 hours, recording hemodynamic data, as well as clinical variables.

All patients showed clinical and hemodynamic improvement. Pulmonary wedge capillary pressure (PWCP) decreased from 18 cmH2O (11-30 cmH2O) to 14 cmH2O (8-15 cmH2O) at 12 hours (p = 0.3) and to 13 cmH2O (8-12 cmH2O) at the end of the infusion period (p = 0.2). Cardiac index increased from 2.1 L/min/m2 (1.8-3.5 L/ min/m2) to 2.86 L/min/m2 (2-4.3 L/min/m2) at 12 hours (p = 0.03) and to 3.08 L/min/m2 at the end of the infusion period (p = 0.02). Tachycardia higher than 120 bpm was present in six patients. No major hypotensive events were present. Mortality to the present is of eight patients.

Levosimendan infusion improved hemodynamics and clinical variables in acute cardiac failure with few side effects in this small series of patients.