1. Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper
- Author
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Farmakis, Dimitrios, Alvarez, Julian, Ben Gal, Tuvia, Brito, Dulce, Fedele, Francesco, Fonseca, Candida, Gordon, Anthony C., Gotsman, Israel, Grossini, Elena, Guarracino, Fabio, Harjola, Veli-Pekka, Hellman, Yaron, Heunks, Leo, Ivancan, Visnja, Karavidas, Apostolos, Kivikko, Matti, Lomivorotov, Vladimir, Longrois, Dan, Masip, Josep, Metra, Marco, Morelli, Andrea, Nikolaou, Maria, Papp, Zoltan, Parkhomenko, Alexander, Poelzl, Gerhard, Pollesello, Piero, Ravn, Hanne Berg, Rex, Steffen, Riha, Hynek, Ricksten, Sven-Erik, Schwinger, Robert H. G., Vrtovec, Bojan, Yilmaz, M. Birhan, Zielinska, Marzenna, Parissis, John, Clinicum, Anestesiologian yksikkö, Department of Diagnostics and Therapeutics, [Farmakis, Dimitrios -- Parissis, John] Univ Athens, Univ Athens, Dept Cardiol, Heart Failure Unit,Univ Attikon, Athens, Greece -- [Alvarez, Julian] Univ Santiago Compostela, Dept Anesthesia, Santiago De Compostela, Spain -- [Alvarez, Julian] Univ Santiago Compostela, Surg ICU, Santiago De Compostela, Spain -- [Ben Gal, Tuvia] Rabin Med Ctr, Cardiol Clin, Petah Tiqwa, Israel -- [Brito, Dulce] Hosp Santa Maria, Dept Cardiol, Ctr Hosp Lisboa Norte, Lisbon, Portugal -- [Fedele, Francesco] Sapienza Univ Rome, Dept Cardiovasc Resp Nephrol Anesthesiol & Geriat, Rome, Italy -- [Fonseca, Candida] Univ Nova Lisboa, Heart Failure Unit, Dept Internal Med,NOVA Med Sch,Fac Ciencias Med, Hosp Sao Francico Xavier,Ctr Hosp Lisbo Ocidental, Lisbon, Portugal -- [Gordon, Anthony C.] Imperial Coll London, Sect Anaesthet Pain Med & Intens Care, London, England -- [Gotsman, Israel] Hadassah Univ Hosp Jerusalem, Inst Heart, Cardiol Clin, Jerusalem, Israel -- [Grossini, Elena] Univ East Piedmont, Physiol Lab, Novara, Italy -- [Guarracino, Fabio] Azienda Osped Univ Pisana, Dept Anaesthesia & Crit Care Med Cardiothorac Ana, Pisa, Italy -- [Harjola, Veli-Pekka] Univ Helsinki, Helsinki Univ Hosp, Emergency Med, Helsinki, Finland -- [Hellman, Yaron] Carmel Hosp, Heart Failure Serv, Haifa, Israel -- [Heunks, Leo] Radboud Univ Nijmegen, Med Ctr, Dept Intens Care, Nijmegen, Netherlands -- [Ivancan, Visnja] Univ Hosp Ctr, Emergency Cardiol Dept, Zagreb, Croatia -- [Karavidas, Apostolos] G Gennimatas Gen Hosp, Dept Cardiol, Athens, Greece -- [Kivikko, Matti -- Pollesello, Piero] Orion Pharma, Crit Care Proprietary Prod, Espoo, Finland -- [Lomivorotov, Vladimir] State Res Inst Circulat Pathol, Dept Anesthesiol & Intens Care, Novosibirsk, Russia -- [Longrois, Dan] Univ Paris Diderot, Hop Uiversitaires Paris Nord Val Seine, Hop Bichat Claude Bernard, Dept Anesthesie Reanimat Chirurg, Paris, France -- [Masip, Josep] Hosp St Joan Despi Moises Broggi, Intens Care Unit, Barcelona, Spain -- [Metra, Marco] Univ & Civil Hosp, Cardiol Clin, Brescia, Italy -- [Morelli, Andrea] Univ Roma La Sapienza, Dept Anesthesiol & Intens Care, Policlin Umberto 1, Rome, Italy -- [Nikolaou, Maria] Sismanoglio & Amalia Fleming Gen Hosp, Dept Cardiol, Athens, Greece -- [Papp, Zoltan] Univ Debrecen, Fac Med, Dept Cardiol, Div Clin Physiol, Debrecen, Hungary -- [Parkhomenko, Alexander] Inst Cardiol, Dept Anesthesiol, Kiev, Ukraine -- [Parkhomenko, Alexander] Inst Cardiol, Intens Care Unit Cardiac Surg Patients, Kiev, Ukraine -- [Poelzl, Gerhard] Univ Klin Innsbruck, Innere Med 3, Innsbruck, Austria -- [Ravn, Hanne Berg] Rigshosp, Ctr Heart, Dept Cardiothorac Anaesthesia, Copenhagen, Denmark -- [Rex, Steffen] Univ Leuven, Dept Cardiovasc Sci, Leuven, Belgium -- [Riha, Hynek] Inst Clin & Expt Med, Dept Anaesthesiol & Intens Care Med, Cardiothorac Anaesthesiol & Intens Care, Prague, Czech Republic -- [Ricksten, Sven-Erik] Univ Gothenburg, Sahlgrenska Univ Hosp, Inst Clin Sci, Dept Anesthesiol & Intens Care Med, Gothenburg, Sweden -- [Schwinger, Robert H. G.] Klinikum Weiden, Med Klin 2, Weiden, Germany -- [Vrtovec, Bojan] Univ Clin Ctr Ljubljana, Dept Cardiol, Ljubljana, Slovenia -- [Yilmaz, M. Birhan] Cumhuriyet Univ, Dept Cardiol, Sivas, Turkey -- [Zielinska, Marzenna] Med Univ Lodz, Dept Intens Cardiac Therapy, Lodz, Poland, Brito, Dulce Alves -- 0000-0003-1278-1847, Lomivorotov, Vladimir -- 0000-0001-8591-6461, Pollesello, Piero -- 0000-0001-6994-768X, YILMAZ, Mehmet Birhan -- 0000-0002-8169-8628, Zielinska, Marzenna -- 0000-0002-0118-8610, Gordon, Anthony -- 0000-0002-0419-547X, YILMAZ, MEHMET BIRHAN -- 0000-0002-8169-8628, Alvarez, Julian -- 0000-0002-2518-0891, MORELLI, ANDREA -- 0000-0001-6065-1006, Riha, Hynek -- 0000-0002-9861-7361, Gotsman, Israel -- 0000-0001-9608-2298, and Rex, Steffen -- 0000-0002-3536-9321
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Levosimendan ,3121 General medicine, internal medicine and other clinical medicine ,Inotropes ,education ,Heart failure ,Cardioprotection ,Cardiogenic shock ,Organ protection - Abstract
WOS: 000384698300056, PubMed ID: 27498374, Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence. The present position paper, derived by a panel of 35 experts in the field of cardiology, cardiac anesthesiology, intensive care medicine, cardiac physiology, and cardiovascular pharmacology from 22 European countries, compiles the existing evidence on the pleiotropic effects of levosimendan, identifies potential novel areas of clinical application and defines the corresponding gaps in evidence and the required research efforts to address those gaps. (C) 2016 The Authors. Published by Elsevier Ireland Ltd., Orion Pharma Oyj/Abp (Finland); Medis d.o.o. (Croatia); Biomed JR Ltd. (Israel); TENAX Therapeutics Ltd. (U.S.A.), This project did not receive any financial support, apart from unrestricted grants by Orion Pharma Oyj/Abp (Finland), Medis d.o.o. (Croatia), Biomed JR Ltd. (Israel), and TENAX Therapeutics Ltd. (U.S.A.) that covered the logistic expenses related to the consensus meeting in Athens on Feb. 26-27, 2016. The attendees did not receive any honoraria. P.P. and M.K. are employees of Orion Pharma.
- Published
- 2016