Jiayong Qiu1, Lei Jia2, Yingying Hao3, Shenshen Huang1, Yaqing Ma1, Xiaofang Li1, Min Wang1, Yimin Mao4. 1. Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China. 2. State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China. 3. Department of Infectious Diseases, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China. 4. Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China. Electronic address: yimin6107@sina.com.
Abstract
AIMS: Right heart failure (RHF), which is caused by a variety of heart and lung diseases, has a high morbidity and mortality rate. Levosimendan is a cardiac inotropic drug and vasodilator. The effect of levosimendan on RHF remains unclear. We sought to evaluate the efficacy and safety of levosimendan in patients with acute RHF. MATERIALS AND METHODS: We systematically searched PubMed, Cochrane Library, EMBASE, and ClinicalTrials.gov to identify studies reporting the efficacy and safety of levosimendan for the treatment of RHF. KEY FINDINGS: Ten trials, including 359 participants from 6 RCTs and 4 self-controlled trials, were evaluated. In the 6 RCTs, we found that patients treated with levosimendan for 24h showed a significant increase in tricuspid annular plane systolic excursion [1.53; 95% CI (0.54, 2.53); P=0.002] and ejection fraction [3.59; 95% CI (1.21, 5.98); P=0.003] as well as a significant reduction in systolic pulmonary artery pressure [-6.15; 95% CI (-9.29, -3.02); P=0.0001] and pulmonary vascular resistance [-39.48; 95% CI (-65.59, -13.38); P=0.003], whereas changes in mean pulmonary pressure were nonsignificant. Adverse events did not significantly differ between the two groups. SIGNIFICANCE: Our study shows that levosimendan exhibits short-term efficacy for treating RHF in patients with a variety of heart and lung diseases. Additional strict multicentre RCTs with long follow-up times and large sample sizes are required to further validate the efficacy and safety of this treatment.
AIMS: Right heart failure (RHF), which is caused by a variety of heart and lung diseases, has a high morbidity and mortality rate. Levosimendan is a cardiac inotropic drug and vasodilator. The effect of levosimendan on RHF remains unclear. We sought to evaluate the efficacy and safety of levosimendan in patients with acute RHF. MATERIALS AND METHODS: We systematically searched PubMed, Cochrane Library, EMBASE, and ClinicalTrials.gov to identify studies reporting the efficacy and safety of levosimendan for the treatment of RHF. KEY FINDINGS: Ten trials, including 359 participants from 6 RCTs and 4 self-controlled trials, were evaluated. In the 6 RCTs, we found that patients treated with levosimendan for 24h showed a significant increase in tricuspid annular plane systolic excursion [1.53; 95% CI (0.54, 2.53); P=0.002] and ejection fraction [3.59; 95% CI (1.21, 5.98); P=0.003] as well as a significant reduction in systolic pulmonary artery pressure [-6.15; 95% CI (-9.29, -3.02); P=0.0001] and pulmonary vascular resistance [-39.48; 95% CI (-65.59, -13.38); P=0.003], whereas changes in mean pulmonary pressure were nonsignificant. Adverse events did not significantly differ between the two groups. SIGNIFICANCE: Our study shows that levosimendan exhibits short-term efficacy for treating RHF in patients with a variety of heart and lung diseases. Additional strict multicentre RCTs with long follow-up times and large sample sizes are required to further validate the efficacy and safety of this treatment.
Authors: Zoltán Papp; Piergiuseppe Agostoni; Julian Alvarez; Dominique Bettex; Stefan Bouchez; Dulce Brito; Vladimir Černý; Josep Comin-Colet; Marisa G Crespo-Leiro; Juan F Delgado; István Édes; Alexander A Eremenko; Dimitrios Farmakis; Francesco Fedele; Cândida Fonseca; Sonja Fruhwald; Massimo Girardis; Fabio Guarracino; Veli-Pekka Harjola; Matthias Heringlake; Antoine Herpain; Leo M A Heunks; Tryggve Husebye; Višnja Ivancan; Kristjan Karason; Sundeep Kaul; Matti Kivikko; Janek Kubica; Josep Masip; Simon Matskeplishvili; Alexandre Mebazaa; Markku S Nieminen; Fabrizio Oliva; Julius G Papp; John Parissis; Alexander Parkhomenko; Pentti Põder; Gerhard Pölzl; Alexander Reinecke; Sven-Erik Ricksten; Hynek Riha; Alain Rudiger; Toni Sarapohja; Robert H G Schwinger; Wolfgang Toller; Luigi Tritapepe; Carsten Tschöpe; Gerhard Wikström; Dirk von Lewinski; Bojan Vrtovec; Piero Pollesello Journal: J Cardiovasc Pharmacol Date: 2020-07 Impact factor: 3.105
Authors: Zoltán Papp; Piergiuseppe Agostoni; Julian Alvarez; Dominique Bettex; Stefan Bouchez; Dulce Brito; Vladimir Černý; Josep Comin-Colet; Marisa G Crespo-Leiro; Juan F Delgado; Istvan Édes; Alexander A Eremenko; Dimitrios Farmakis; Francesco Fedele; Cândida Fonseca; Sonja Fruhwald; Massimo Girardis; Fabio Guarracino; Veli-Pekka Harjola; Matthias Heringlake; Antoine Herpain; Leo Ma Heunks; Tryggve Husebye; Višnja Ivancan; Kristjan Karason; Sundeep Kaul; Matti Kivikko; Janek Kubica; Josep Masip; Simon Matskeplishvili; Alexandre Mebazaa; Markku S Nieminen; Fabrizio Oliva; Julius-Gyula Papp; John Parissis; Alexander Parkhomenko; Pentti Põder; Gerhard Pölzl; Alexander Reinecke; Sven-Erik Ricksten; Hynek Riha; Alain Rudiger; Toni Sarapohja; Robert Hg Schwinger; Wolfgang Toller; Luigi Tritapepe; Carsten Tschöpe; Gerhard Wikström; Dirk von Lewinski; Bojan Vrtovec; Piero Pollesello Journal: Card Fail Rev Date: 2020-07-08