• John N Nanas, Panagiotis P Papazoglou, John V Terrovitis, John Kanakakis, Argirios Dalianis, Elias Tsolakis, Eleftheria P Tsagalou, Nikolaos Agrios, Kostantinos Christodoulou, and Maria I Anastasiou-Nana.
• University of Athens School of Medicine, Department of Clinical Therapeutics, Alexandra Hospital, Athens, Greece. jnanas@ath.forthnet.gr <jnanas@ath.forthnet.gr>
• Am. J. Cardiol. 2004 Nov 15;94(10):1329-32.

AbstractA 24-hour infusion of levosimendan was added to dobutamine in 18 patients (aged 63 +/- 9 years) hospitalized for management of decompensated New York Heart Association functional class IV heart failure refractory to a continuous 24-hour infusion of dobutamine (10 microg/kg/min) and furosemide (10 mg/hour); the primary study end point was a >or=40% increase in cardiac index and a >or=25% decrease in pulmonary capillary wedge pressure compared with pretreatment measurements. The primary end point was reached in one of the patients treated with dobutamine alone versus 7 patients (39%) treated with levosimendan and dobutamine combined (p = 0.008), whereas at 24 hours, the combined treatment was associated with a 0.76 +/- 0.78 L/min/m(2) (p = 0.001) mean increase in cardiac index and a 6.4 +/- 7.3 mm Hg (p = 0.002) mean decrease in pulmonary capillary wedge pressure compared with measurements obtained after 24 hours of dobutamine infusion alone. Symptoms were alleviated in all patients, and all but 3 were discharged from the hospital.

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