The Use of Levosimendan in Patients Undergoing Left Ventricular Assist Device Implantation to Mitigate the Risk of Early Postoperative Right Heart Failure (Euro LEVO-LVAD Study): An Analysis of the EUROMACS Registry

摘要: PurposeRight heart failure (RHF) has been reported in 20% to 50% of patients receiving an LVAD. However, optimal management strategies are not well described. In the EUROMACS RHF score study, early severe RHF was reported in 22% of patients on LVAD. Patients who developed RHF had significantly increased mortality. Furthermore, patients who develop severe RHF have a 4-fold increase in the length of ICU stay. In contrast to conventional inotropes, levosimendan (LEVO) is a first-in-class inotropic agent that acts as a calcium sensitizer. It increases cardiac output and stroke volume and reduces peripheral vascular resistance without increasing myocardial oxygen consumption, and therefore without an increased risk of serious arrhythmia or myocardial “exhaustion”. Furthermore, it has a long therapeutic effect that may last for weeks, due to the long half-life of one of its active metabolites. In a recent two …