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Related Concept Videos

Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...

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Related Experiment Video

Updated: Jun 26, 2026

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
14:24

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model

Published on: January 21, 2018

Levosimendan: from basic science to clinical practice.

John T Parissis1, Pinelopi Rafouli-Stergiou, Ioannis Paraskevaidis

  • 1Heart Failure Clinic and Second Cardiology Department, Attikon University Hospital, Maroussi, Athens, Greece. jparissis@yahoo.com

Heart Failure Reviews
|December 23, 2008
PubMed
Summary
This summary is machine-generated.

Levosimendan enhances heart function through calcium sensitization and vasodilation. While not improving overall prognosis in acute heart failure syndromes, it may benefit short-term mortality in specific patient groups.

More Related Videos

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Related Experiment Videos

Last Updated: Jun 26, 2026

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model
14:24

Percutaneous Contrast Echocardiography-guided Intramyocardial Injection and Cell Delivery in a Large Preclinical Model

Published on: January 21, 2018

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
09:20

Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction

Published on: February 13, 2021

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Levosimendan is a cardiac enhancer with positive inotropic and vasodilatory effects.
  • It acts via calcium sensitization and opening ATP-sensitive potassium channels.
  • It is the most studied calcium sensitizer in clinical practice for acute heart failure syndromes (AHFS).

Purpose of the Study:

  • To review the clinical efficacy and indications of levosimendan in heart failure management.
  • To discuss its mechanisms of action, including immunomodulatory and anti-apoptotic properties.
  • To evaluate its impact on mortality and current guideline recommendations.

Main Methods:

  • Review of clinical practice data and mortality trials involving levosimendan.
  • Analysis of hemodynamic and symptomatic improvements compared to traditional inotropes.
  • Assessment of levosimendan's role in specific patient subgroups and guideline adherence.

Main Results:

  • Levosimendan demonstrated greater hemodynamic and symptomatic improvement than traditional inotropes in AHFS.
  • Recent trials indicated no overall improvement in short- and long-term prognosis compared to dobutamine or placebo.
  • A potential short-term mortality benefit was observed in patients with prior CHF on beta-blockers.

Conclusions:

  • Levosimendan is indicated for symptomatic low cardiac output heart failure secondary to systolic dysfunction without severe hypotension (ESC Class IIa, Level B).
  • Its immunomodulatory and anti-apoptotic effects may offer additional biological benefits.
  • Clinical application requires careful patient selection, especially considering recent mortality data.