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Intermittent levosimendan treatment in patients with severe congestive heart failure

Petri O Tuomainen1, Jarkko Magga, Pekka Timonen

  • 1Department of Internal Medicine, Kuopio University Hospital and University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland. Petri.Tuomainen@uef.fi

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|March 19, 2013
PubMed

Insights

Intermittent administration of Levosimendan (LS) in severe congestive heart failure (CHF) patients reduced vasoactive peptides and improved symptoms, but without long-term benefits on exercise capacity.

Area of Science:

  • Cardiology
  • Pharmacology
  • Heart Failure Research

Background:

  • Severe congestive heart failure (CHF) presents significant challenges in treatment.
  • Levosimendan (LS) is an inodilator with potential therapeutic applications in CHF.

Purpose of the Study:

  • To investigate the long-term effects of intermittent Levosimendan (LS) treatment on the pathophysiology of severe congestive heart failure (CHF).

Main Methods:

  • Thirteen patients with moderate to severe CHF received three 24-hour intravenous infusions of LS at 3-week intervals.
  • Evaluated exercise capacity via bicycle ergospirometry and patient well-being using the Minnesota Living with Heart Failure Questionnaire (MLHFQ).
  • Measured key laboratory parameters, including plasma NT-proANP, NT-proBNP, NT-proXNP, and norepinephrine (NE), before and after each treatment.

Main Results:

  • Levosimendan infusions were generally well-tolerated, with one patient discontinuing due to ventricular tachycardia.
  • While exercise capacity (VO2max) did not significantly improve, patient-reported symptoms showed a significant decrease (P < 0.0001).
  • Plasma levels of NT-proANP, NT-proBNP, and NT-proXNP decreased during infusions but returned to baseline within 3 weeks; no long-term changes in norepinephrine were observed.

Conclusions:

  • Intermittent Levosimendan treatment effectively reduced plasma vasoactive peptide levels repetitively, but these effects were transient.
  • Patients experienced symptom improvement throughout the study, despite a lack of objective enhancement in exercise capacity.
  • Further research is needed to determine the prognostic significance of these observed effects in CHF patients.
Abstract

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