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Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine
| Content Provider | MDPI |
|---|---|
| Author | Juguet, William Fard, Damien Faivre, Laureline Koutsoukis, Athanasios Deguillard, Camille Mongardon, Nicolas Mekontso-Dessap, Armand Huguet, Raphaelle Lim, Pascal |
| Copyright Year | 2020 |
| Description | Randomized studies showed that Dobutamine and Levosimendan have similar impact on outcome but their combination has never been assessed in acute decompensated heart failure (ADHF) with low cardiac output. This is a retrospective, single-center study that included 89 patients (61 ± 15 years) admitted for ADHF requiring inotropic support. The first group consisted of patients treated with dobutamine alone (n = 42). In the second group, levosimendan was administered on top of dobutamine, when the superior vena cava oxygen saturation (ScVO2) remained n = 47). The primary outcome was the occurrence of major cardiovascular events (MACE) at 6 months, defined as all cause death, heart transplantation or need for mechanical circulatory support. Baseline clinical characteristics were similar in both groups. At day-3, the ScVO2 target (>60%) was reached in 36% and 32% of patients in the dobutamine and dobutamine-levosimendan group, respectively. After adding levosimendan, 72% of the dobutamine-levosimendan-group reached the ScVO2 target value at dobutamine weaning. At six months, 42 (47%) patients experienced MACE (n = 29 for death). MACE was less frequent in the dobutamine-levosimendan (32%) than in the dobutamine-group (64%, p = 0.003). Independent variables associated with outcome were admission systolic blood pressure and dobutamine-levosimendan strategy (OR = 0.44 (0.23–0.84), p = 0.01). In conclusion, levosimendan added to dobutamine may improve the outcome of ADHF refractory to dobutamine alone. |
| Starting Page | 3605 |
| e-ISSN | 20770383 |
| DOI | 10.3390/jcm9113605 |
| Journal | Journal of clinical medicine |
| Issue Number | 11 |
| Volume Number | 9 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2020-11-09 |
| Access Restriction | Open |
| Subject Keyword | Journal of clinical medicine Journal of Clinical Medicine Cardiology and Cardiovascular Diseases Acute Decompensated Heart Failure Levosimendan Dobutamine Vena Cava Oxygen Saturation |
| Content Type | Text |
| Resource Type | Article |
