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Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation

Left ventricular assist device (LVAD) therapy has been instrumental in saving lives of patients with end-stage heart failure (HF). Recent generation devices have short-to-mid-term survival rates close to heart transplantation. Unfortunately, up to 1 in 4 patients develop a life-threatening right-sid...

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Autores principales: Abdelshafy, Mahmoud, Elsherbini, Hagar, Elkoumy, Ahmed, Simpkin, Andrew J., Elzomor, Hesham, Caliskan, Kadir, Soliman, Osama
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9095918/
https://www.ncbi.nlm.nih.gov/pubmed/35571194
http://dx.doi.org/10.3389/fcvm.2022.888136
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author Abdelshafy, Mahmoud
Elsherbini, Hagar
Elkoumy, Ahmed
Simpkin, Andrew J.
Elzomor, Hesham
Caliskan, Kadir
Soliman, Osama
author_facet Abdelshafy, Mahmoud
Elsherbini, Hagar
Elkoumy, Ahmed
Simpkin, Andrew J.
Elzomor, Hesham
Caliskan, Kadir
Soliman, Osama
author_sort Abdelshafy, Mahmoud
collection PubMed
description Left ventricular assist device (LVAD) therapy has been instrumental in saving lives of patients with end-stage heart failure (HF). Recent generation devices have short-to-mid-term survival rates close to heart transplantation. Unfortunately, up to 1 in 4 patients develop a life-threatening right-sided HF (RHF) early post LVAD implantation, with high morbidity and mortality rate, necessitating prolonged ICU stay, prolonged inotropic support, and implantation of a right-ventricular assist device. Pre-operative optimization of HF therapy could help in prevention, and/or mitigation of RHF. Levosimendan (LEVO) is a non-conventional inotropic agent that works by amplifying calcium sensitivity of troponin C in cardiac myocytes, without increasing the intra-cellular calcium or exacerbating ischemia. LEVO acts as an inodilator, which reduces the cardiac pre-, and after-load. LEVO administration is associated with hemodynamic improvements. Despite decades long of the use of LVAD and more than two decades of the use of LEVO for HF, the literature on LEVO use in LVAD is very limited. In this paper, we sought to conduct a systematic review to synthesize evidence related to the use of LEVO for the mitigation and/or prevention of RHF in patients undergoing LVAD implantation.
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spelling pubmed-90959182022-05-13 Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation Abdelshafy, Mahmoud Elsherbini, Hagar Elkoumy, Ahmed Simpkin, Andrew J. Elzomor, Hesham Caliskan, Kadir Soliman, Osama Front Cardiovasc Med Cardiovascular Medicine Left ventricular assist device (LVAD) therapy has been instrumental in saving lives of patients with end-stage heart failure (HF). Recent generation devices have short-to-mid-term survival rates close to heart transplantation. Unfortunately, up to 1 in 4 patients develop a life-threatening right-sided HF (RHF) early post LVAD implantation, with high morbidity and mortality rate, necessitating prolonged ICU stay, prolonged inotropic support, and implantation of a right-ventricular assist device. Pre-operative optimization of HF therapy could help in prevention, and/or mitigation of RHF. Levosimendan (LEVO) is a non-conventional inotropic agent that works by amplifying calcium sensitivity of troponin C in cardiac myocytes, without increasing the intra-cellular calcium or exacerbating ischemia. LEVO acts as an inodilator, which reduces the cardiac pre-, and after-load. LEVO administration is associated with hemodynamic improvements. Despite decades long of the use of LVAD and more than two decades of the use of LEVO for HF, the literature on LEVO use in LVAD is very limited. In this paper, we sought to conduct a systematic review to synthesize evidence related to the use of LEVO for the mitigation and/or prevention of RHF in patients undergoing LVAD implantation. Frontiers Media S.A. 2022-04-28 /pmc/articles/PMC9095918/ /pubmed/35571194 http://dx.doi.org/10.3389/fcvm.2022.888136 Text en Copyright © 2022 Abdelshafy, Elsherbini, Elkoumy, Simpkin, Elzomor, Caliskan and Soliman. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Abdelshafy, Mahmoud
Elsherbini, Hagar
Elkoumy, Ahmed
Simpkin, Andrew J.
Elzomor, Hesham
Caliskan, Kadir
Soliman, Osama
Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation
title Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation
title_full Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation
title_fullStr Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation
title_full_unstemmed Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation
title_short Perioperative Levosimendan Infusion in Patients With End-Stage Heart Failure Undergoing Left Ventricular Assist Device Implantation
title_sort perioperative levosimendan infusion in patients with end-stage heart failure undergoing left ventricular assist device implantation
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9095918/
https://www.ncbi.nlm.nih.gov/pubmed/35571194
http://dx.doi.org/10.3389/fcvm.2022.888136
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