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The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery

Background: Postoperative myocardial dysfunction following cardiac surgery is a relatively common occurrence. Levosimendan, a calcium sensitizer and inotropic drug, has shown potential in improving outcomes for patients with low preoperative ejection fraction (EF) and myocardial dysfunction after ca...

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Autores principales: Leivaditis, Vasileios, Grapatsas, Konstantinos, Papaporfyriou, Anastasia, Galanis, Michail, Koletsis, Efstratios, Charokopos, Nikolaos, Haussmann, Erich, Kaplunov, Vladislav, Papatriantafyllou, Athanasios, Dahm, Manfred
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455812/
https://www.ncbi.nlm.nih.gov/pubmed/37623345
http://dx.doi.org/10.3390/jcdd10080332
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author Leivaditis, Vasileios
Grapatsas, Konstantinos
Papaporfyriou, Anastasia
Galanis, Michail
Koletsis, Efstratios
Charokopos, Nikolaos
Haussmann, Erich
Kaplunov, Vladislav
Papatriantafyllou, Athanasios
Dahm, Manfred
author_facet Leivaditis, Vasileios
Grapatsas, Konstantinos
Papaporfyriou, Anastasia
Galanis, Michail
Koletsis, Efstratios
Charokopos, Nikolaos
Haussmann, Erich
Kaplunov, Vladislav
Papatriantafyllou, Athanasios
Dahm, Manfred
author_sort Leivaditis, Vasileios
collection PubMed
description Background: Postoperative myocardial dysfunction following cardiac surgery is a relatively common occurrence. Levosimendan, a calcium sensitizer and inotropic drug, has shown potential in improving outcomes for patients with low preoperative ejection fraction (EF) and myocardial dysfunction after cardiac surgery. This study aims to evaluate the efficacy of levosimendan in optimizing the surgical outcome for such patients. Methods: A retrospective analysis was conducted on 314 patients with preoperative severe heart failure who underwent cardiac surgery. Among them, 184 patients received perioperative adjunctive therapy with levosimendan, while a comparable group of 130 patients received conventional treatment. Results: The use of levosimendan demonstrated several advantages in postoperative outcomes. It significantly improved short- and long-term survival rates after cardiac surgery, enhanced hemodynamic stability, reduced the requirement for inotropic support, and facilitated faster weaning from ventilator support. Patients who received levosimendan reported reduced angina and dyspnea symptoms, as well as fewer postoperative arrhythmias. Furthermore, levosimendan helped minimize myocardial injury inevitable after cardiac surgery. The levosimendan group also exhibited a notable reduction in hospital readmissions. Conclusions: This study provides evidence of several benefits associated with the perioperative use of levosimendan. However, further prospective randomized studies are warranted to standardize and comprehensively document the other perioperative therapies, in order to validate these findings and establish stronger conclusions.
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spelling pubmed-104558122023-08-26 The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery Leivaditis, Vasileios Grapatsas, Konstantinos Papaporfyriou, Anastasia Galanis, Michail Koletsis, Efstratios Charokopos, Nikolaos Haussmann, Erich Kaplunov, Vladislav Papatriantafyllou, Athanasios Dahm, Manfred J Cardiovasc Dev Dis Article Background: Postoperative myocardial dysfunction following cardiac surgery is a relatively common occurrence. Levosimendan, a calcium sensitizer and inotropic drug, has shown potential in improving outcomes for patients with low preoperative ejection fraction (EF) and myocardial dysfunction after cardiac surgery. This study aims to evaluate the efficacy of levosimendan in optimizing the surgical outcome for such patients. Methods: A retrospective analysis was conducted on 314 patients with preoperative severe heart failure who underwent cardiac surgery. Among them, 184 patients received perioperative adjunctive therapy with levosimendan, while a comparable group of 130 patients received conventional treatment. Results: The use of levosimendan demonstrated several advantages in postoperative outcomes. It significantly improved short- and long-term survival rates after cardiac surgery, enhanced hemodynamic stability, reduced the requirement for inotropic support, and facilitated faster weaning from ventilator support. Patients who received levosimendan reported reduced angina and dyspnea symptoms, as well as fewer postoperative arrhythmias. Furthermore, levosimendan helped minimize myocardial injury inevitable after cardiac surgery. The levosimendan group also exhibited a notable reduction in hospital readmissions. Conclusions: This study provides evidence of several benefits associated with the perioperative use of levosimendan. However, further prospective randomized studies are warranted to standardize and comprehensively document the other perioperative therapies, in order to validate these findings and establish stronger conclusions. MDPI 2023-08-03 /pmc/articles/PMC10455812/ /pubmed/37623345 http://dx.doi.org/10.3390/jcdd10080332 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Leivaditis, Vasileios
Grapatsas, Konstantinos
Papaporfyriou, Anastasia
Galanis, Michail
Koletsis, Efstratios
Charokopos, Nikolaos
Haussmann, Erich
Kaplunov, Vladislav
Papatriantafyllou, Athanasios
Dahm, Manfred
The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery
title The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery
title_full The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery
title_fullStr The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery
title_full_unstemmed The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery
title_short The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery
title_sort perioperative use of levosimendan as a means of optimizing the surgical outcome in patients with severe heart insufficiency undergoing cardiac surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10455812/
https://www.ncbi.nlm.nih.gov/pubmed/37623345
http://dx.doi.org/10.3390/jcdd10080332
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