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June 2019 post

6/3/2019 12:48:02 PM

Back from the HEART FAILURE congress in Athens with pleasant memories, new acquaintances, and a big bag with information and ideas.

LEODOR study on “repetitive use of levosimendan in advanced heart failure patients” has been discussed in the main program (see presentation in MyESC) and an investigator meeting has been held to discuss about the progress in initiation of the centers and enrollment of the patients.

As it regards the inodilator levosimendan, many posters were presented and a series of tutorials on i.v. vasoactive drugs in the treatment of acute and advanced heart failure was held by 12 speakers from Austria, Cyprus, Finland, Germany, Greece, Hungary, Italy, Spain, Sweden, and Switzerland. The lectures were recorded and the videos are available on the landing page www.acutehf.com/hf for educational purposes.

The speakers agreed that, despite the use of i.v. vasoactive drugs, diuretics, vasodilators and inotropes, for correcting hemodynamic dysfunction in patients with congestive heart failure has been described over many decades, insufficient data has been collected on their effects on Quality of life (QoL) and long term survival. Of particular note is that for inotropes belonging to the cardiac glycoside, catecholamine, and phosphodiesterase inhibitor families, data on the impact of these agents on QoL and survival are not positive and in several cases indicate an increase in mortality risk.

In acute heart failure, selecting the proper agent according to patients’ clinical profile and limiting usage to the shortest time at the lowest effective dose are important considerations to optimize inotrope use. In these settings, levosimendan bears an advantage also due to its beneficial renal effects. Levosimendan’s overall hemodynamic profile and clinical tolerability, combined with its extended duration of effect, has encouraged its intermittent use also in patients with advanced heart failure, to promote functional independence and quality of life and avert the need for unplanned hospitalizations resulting from episodes of decompensation. Further clinical research is in progress to refine the drug’s use for this purpose.