Cor Vasa 2007, 49(3):108-110

Levosimendan-revised indications and posology

Jindřich Špinar^1,*, Jiří Vítovec²

¹ Interní-kardiologická klinika, Fakultní nemocnice Brno-Bohunice

² I. interní-kardioangiologická klinika, Fakultní nemocnice u sv. Anny, Brno, Česká republika

Acute heart failure is a very common emergency. This syndrome encompasses at least four diagnostic entities: cardiogenic shock, pulmonary edema, hypertensive crisis, and acute exacerbation of heart failure. The new recommendations for the diagnosis and treatment of acute heart failure developed by the European Society of Cardiology and by the Czech Society of Cardiology have included levosimendan as an option. However, large clinical trials have led to a revision of the main indications for and posology of this drug. The main indication is currently decompensation of the patient with chronic heart failure, treated with beta-blockers, which are not to be withdrawn. A bolus is no longer recommended for all patients;
the total dose has been halved while extending the period of administration. The two main side effects, arrhythmia and hypotension, are also clearly identified.

Keywords: Acute heart failure; Levosimendan; Indication; Dosing

Published: March 1, 2007  Show citation