Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine - Université Paris-Est-Créteil-Val-de-Marne Access content directly
Journal Articles Journal of Clinical Medicine Year : 2020

Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine

William Juguet
  • Function : Author
Damien Fard
Laureline Faivre
  • Function : Author
Athanasios Koutsoukis
Camille Deguillard
  • Function : Author
Nicolas Mongardon
Raphaelle Huguet
  • Function : Author
Pascal Lim
  • Function : Author

Abstract

Randomized studies showed that Dobutamine and Levosimendan have similar impact on outcome but their combination has never been assessed in acute decompensated heart failure (ADHF) with low cardiac output. This is a retrospective, single-center study that included 89 patients (61 ± 15 years) admitted for ADHF requiring inotropic support. The first group consisted of patients treated with dobutamine alone (n = 42). In the second group, levosimendan was administered on top of dobutamine, when the superior vena cava oxygen saturation (ScVO2) remained <60% after 3 days of dobutamine treatment (n = 47). The primary outcome was the occurrence of major cardiovascular events (MACE) at 6 months, defined as all cause death, heart transplantation or need for mechanical circulatory support. Baseline clinical characteristics were similar in both groups. At day-3, the ScVO2 target (>60%) was reached in 36% and 32% of patients in the dobutamine and dobutamine-levosimendan group, respectively. After adding levosimendan, 72% of the dobutamine-levosimendan-group reached the ScVO2 target value at dobutamine weaning. At six months, 42 (47%) patients experienced MACE (n = 29 for death). MACE was less frequent in the dobutamine-levosimendan (32%) than in the dobutamine-group (64%, p = 0.003). Independent variables associated with outcome were admission systolic blood pressure and dobutamine-levosimendan strategy (OR = 0.44 (0.23–0.84), p = 0.01). In conclusion, levosimendan added to dobutamine may improve the outcome of ADHF refractory to dobutamine alone.

Dates and versions

hal-04395575 , version 1 (15-01-2024)

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William Juguet, Damien Fard, Laureline Faivre, Athanasios Koutsoukis, Camille Deguillard, et al.. Levosimendan Plus Dobutamine in Acute Decompensated Heart Failure Refractory to Dobutamine. Journal of Clinical Medicine, 2020, 9 (11), pp.3605. ⟨10.3390/jcm9113605⟩. ⟨hal-04395575⟩

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