If we had a way to reduce the risk of life-threatening complications after cardiac surgery would we use it? Of course we would. It is for reason that this blog post highlights the recent work of Dr. Qiang and colleagues . In the most up-to-date and comprehensive research of its kind these researchers identified and analysed data from 25 randomised controlled trials (RCTs) that compared perioperative use of levosimendan with control (placebo, conventional inotropes or intra-aortic balloon pump) in 3247 adult cardiac surgery patients and reported an impressive array of benefits. The main results are that:
Data of this sort make a strong case for the peri-operative use of levosimendan in adult cardiac surgery but they can’t answer every question. In particular, the outcomes of some recent randomised trials [2,3,4] points to the need for further work to define the optimal dose-range: Qiang and colleagues  suggest that adult cardiac surgery may be a situation where initial bolus dosing and a relatively high infusion rate may be needed to secure the full clinical benefit of levosimendan unique inodilator actions. If that proves indeed to be the case then the well-documented safety profile of levosimendan will be another feature favouring its use.
1. Qiang H et al. J Cardiovasc Pharmacol 2018 Publish Ahead of Print Apr 3. PMID: 29672418, DOI: 10.1097/FJC.0000000000000584.
2. Landoni G et al. N Engl J Med. 2017;376(21):2021–2031.
3. Mahta RH et al. N Engl J Med. 2017;376(21):2032–2042.
4. Cholley B et al. JAMA. 2017;318(6):548–556.
Professor Gerhard Pölzl highlights Hospitalisation for the management of acute decompensation being a critical moment in the trajectory of heart failure (HF) and one that has gloomy prognostic implications for many patients.
Professor Gerhard Pölzl highlights the LION-Heart and LAICA clinical trials.
Professor Gerhard Pölzl discusses the Heart Failure Association of the European Society of Cardiology annual meeting, where several sessions were held on the use of levosimendan in heart failure.
Professor Gerhard Pölzl discusses the interplay between the acutely compromised heart and the kidneys and how the optimal treatment for individual cases is complex.
Professor Gerhard Pölzl reports primary results from the LION-HEART study in the management of advanced heart failure where among secondary endpoints, patients treated with levosimendan experienced a reduction in the rate of HF-related hospitalisation compared with placebo.
The HFA-ESC has issued a fresh position paper [Crespo-Leiro MG et al. Eur J Heart Fail. 2018 May 27. doi: 10.1002/ejhf.1236]. Here’s our first take on some highlights.
Professor Cynthia M Dougherty and colleagues outline an array of options for the treatment of advanced heart failure (HF) that create – quite reasonably – the impression that we are in a golden age of therapeutic possibilities for this difficult condition.
Thoughts from the expert meeting organised by the Heart Failure Clinic, Attikon University Hospital, 2018.
If we had a way to reduce the risk of life-threatening complications after cardiac surgery would we use it? Of course we would. It is for reason that this blog post highlights the recent work of Dr. Qiang and colleagues. See the details here.
Professor Pölzl highlights a Supplement added at the end of 2018 to the European Heart Journal.