Hemodynamic and neurohumoral effects of continuous infusion of levosimendan in patients with congestive heart failure
Markku S. Nieminen, MD, FACC, FESC*,
Juha Akkila, MSc ,
Gerd Hasenfuss, MD, FACC ,
Franz X. Kleber, MD, PhD ,
Lasse A. Lehtonen, MD, PhD,
Veselin Mitrovic, MD||,
Olof Nyquist, MD, PhD¶,
Willem J. Remme, MD, PhD, FACC# on behalf of the Study Group**
* Helsinki University, Helsinki, Finland
Orion Pharma Research, Espoo, Finland
University of Göttingen, Göttingen, Germany
Humboldt University, Berlin, Germany
|| Kerckhoff Clinic, Bad-Neuheim, Germany
¶ Huddinge Hospital, Stockholm, Sweden
# University Hospital, Utrecht, Netherlands
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Figure 1 Percentage of patients responding to levosimendan or placebo/vehicle or dobutamine (DO) by achieving predefined hemodynamic responses (stroke volume [SV], pulmonary capillary wedge pressure [PCWP]) at 23 h to 24 h, or requiring dose reduction for specified hemodynamic changes at any time during infusion, or having adverse dose-limiting events (DLE).
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Figure 2 Time course of levosimendan treatment effects on pulmonary capillary wedge pressure (A), stroke volume (B) and heart rate (C). Data are placebo-adjusted means ± SEM. Dosages of levosimendan (LS) refer to continuous infusion; see text for details of bolus starting doses. Open circle = levosimendan 0.05 µg/kg/min; open triangle = levosimendan 0.1 µg/kg/min; open square = levosimendan 0.2 µg/kg/min; open diamond = levosimendan 0.4 µg/kg/min; upside-down triangle = levosimendan 0.6 µg/kg/min; closed circle = dobutamine.
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