Efficacy and safety of intermittent, long-term, concomitant dobutamine and levosimendan infusions in severe heart failure refractory to dobutamine alone

Am J Cardiol. 2005 Mar 15;95(6):768-71. doi: 10.1016/j.amjcard.2004.11.033.

Abstract

Thirty-six consecutive patients in New York Heart Association functional class IV, who were resistant to 24-hour continuous dobutamine infusion, were treated with continuous infusions of dobutamine 10 microg/kg/min for > or =48 hours (group I, n = 18), followed by weekly intermittent 8-hour infusions or more often if needed. In group II (n = 18), after the initial 24-hour infusion of dobutamine, a 24-hour levosimendan infusion was added followed by biweekly 24-hour infusions. The addition of intermittent levosimendan infusions prolonged the survival of patients with advanced heart failure refractory to intermittent dobutamine infusions (45-day survival rates were 6% and 61% in groups I and II, respectively; p = 0.0002, log-rank test).

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cardiotonic Agents / administration & dosage*
  • Cardiotonic Agents / adverse effects
  • Chronic Disease
  • Dobutamine / administration & dosage*
  • Dobutamine / adverse effects
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Resistance
  • Drug Therapy, Combination
  • Exercise Test / drug effects
  • Female
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Hemodynamics / drug effects
  • Humans
  • Hydrazones / administration & dosage*
  • Hydrazones / adverse effects
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pyridazines / administration & dosage*
  • Pyridazines / adverse effects
  • Radionuclide Ventriculography
  • Risk
  • Simendan
  • Survival Rate

Substances

  • Cardiotonic Agents
  • Hydrazones
  • Pyridazines
  • Simendan
  • Dobutamine