Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Issue's catalogue ➤ КФК. 2021; 18 (1): 1-92 ➤ Влияние левосимендана на почечную функцию у пациентов с острой сердечной недостаточностью

Effects of levosimendan on renal function in patients with acute heart failure

Authors: Rakhimov A.Z., Rustamov B.E., Pirtskhalava S.D., Asymbekova E.U.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2021-18-1-37-45

UDC: 616.61-008.64:616.12-008.46]:615.2

Link: Clinical Physiology of Blood Circulaiton. 2021; 1 (18): 37-45

Quote as: Rakhimov A.Z., Rustamov B.E., Pirtskhalava S.D., Asymbekova E.U. Effects of levosimendan on renal function in patients with acute heart failure. Clinical Physiology of Circulation. 2021; 18 (1): 37–45 (in Russ.). DOI: 10.24022/1814-6910-2021-18-1-37-45

Keywords:  levosimendan acute heart failure renal dysfunction cardiorenal syndrome low cardiac output syndrome

Received / Accepted:  18.06.2020 / 27.07.2020

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Abstract

Non-glycoside inotropic drugs can be used for short-term treatment of acute heart failure with renal dysfunction (cardiorenal syndrome), especially in conditions with low cardiac output, in order to avoid renal hypoperfusion. Levosimendan appears to be a promising option for improving renal perfusion and improving renal dysfunction in patients with acute heart failure. Despite the neutral results of recent randomized trials, at the current stage it seems obvious that levosimendan is appropriate for use in cardiology and cardiac surgery in patients with acute heart failure with low cardiac output and refractory to diuretics, especially in the presence of renal dysfunction. Its use can help overcome the most difficult and dangerous period during this disease

References

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****
  1. Papp Z., Edes I., Fruhwald S., De Hert S.G., Salmenpera M., Leppikangas H. et al. Levosimendan: molecular mechanisms and clinical implications: consensus of experts on the mechanisms of action of levosimendan. Int. J. Cardiol. 2012; 159: 82–7. DOI: 10.1016/j.ijcard.2011.07.022
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  3. Brixius K., Reicke S., Schwinger R.H. Beneficial effects of the Ca(2+) sensitizer levosimendan in human myocardium. Am. J. Physiol. Heart Circ. Physiol. 2002; 282 (1): H131–7. DOI: 10.1152/ajpheart.2002. 282.1.H131
  4. Ukkonen H., Saraste M., Akkila J., Knuuti M.J., Lehikoinen P., Na° gren K. et al. Myocardial efficiency during calcium sensitization with levosimendan: a noninvasive study with positron emission tomography and echocardiography in healthy volunteers. Clin. Pharmacol. Ther. 1997; 61: 596–607. DOI: 10.1016/S0009-9236(97)90139-9
  5. Nieminen M.S., Pollesello P., Vajda G., Papp Z. Effects of levosimendan on the energy balance: preclinical and clinical evidence. J. Cardiovasc. Pharmacol. 2009; 53 (4): 302–10. DOI: 10.1097/FJC.0b013e31819c9a17
  6. Louhelainen M., Vahtola E., Kaheinen P., Leskinen H., Merasto S., Kytö V. et al. Effects of levosimendan on cardiac remodeling and cardiomyocyte apoptosis in hypertensive Dahl/Rapp rats. Br. J. Pharmacol. 2007; 150 (7): 851–61. DOI: 10.1038/sj.bjp.0707157
  7. Nieminen M.S., Fruhwald S., Heunks L.M., Suominen P.K., Gordon A.C., Kivikko M., Pollesello P. Levosimendan: current data, clinical use and future development. Heart Lung Vessels. 2013; 5 (4): 227–45.
  8. Mebazaa A., Nieminen M.S., Packer M., CohenSolal A., Kleber F.X., Pocock S.J. et al. SURVIVE Investigators Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. JAMA. 2007; 297 (17): 1883–91. DOI: 10.1001/jama.297.17.1883
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  14. Pagel P.S., Hettrick D.A., Warltier D.C. Influence of levosimendan, pimobendan, and milrinone on the regional distribution of cardiac output in anaesthetized dogs. Br. J. Pharmacol. 1996; 119 (3): 609–15. DOI: 10.1111/j.1476-5381.1996.tb15716.x
  15. Zager R.A., Johnson A.C., Lund S., Hanson S.Y., Abrass C.K. Levosimendan protects against experimental endotoxemic acute renal failure. Am. J. Physiol. Renal. Physiol. 2006; 290 (6): F1453–62. DOI: 10.1152/ajprenal.00485.2005
  16. Rehberg S., Ertmer C., Vincent J.L., Spiegel H.U., Köhler G., Erren M. et al. Effects of combined arginine vasopressin and levosimendan on organ function in ovine septic shock. Crit. Care Med. 2010; 38 (10): 2016–23. DOI: 10.1097/CCM.0b013e3181ef4694
  17. Grossini E., Molinari C., Pollesello P., Bellomo G., Valente G., Mary D. et al. Levosimendan protection against kidney ischemia/reperfusion injuries in anesthetized pigs. J. Pharmacol. Exp. Ther. 2012; 342 (2): 376–88. DOI: 10.1124/jpet.112.193961
  18. Yakut N., Yasa H., Bahriye Lafci B., Ortac R., Tulukoglu E., Aksun M. et al. The influence of levosimendan and iloprost on renal ischemia-reperfusion: an experimental study. Interact. Cardiovasc. Thorac. Surg. 2008; 7: 235–9. DOI: 10.1510/icvts.2007.161356
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  20. Bragadottir G., Redfors B., Ricksten S.E. Effects of levosimendan on glomerular filtration rate, renal blood flow, and renal oxygenation after cardiac surgery with cardiopulmonary bypass: a randomized placebo-controlled study. Crit. Care Med. 2013; 41 (10): 2328–35. DOI: 10.1097/CCM.0b013e31828e946a
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  22. Follath F., Cleland J.G., Just H., Papp J.G., Scholz H., Peuhkurinen K. et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet. 2002; 360: 196–202. DOI: 10.1016/S0140-6736(02)09455-2
  23. Lannemyr L., Ricksten S.-E., Rundqvist B., Andersson B., Bartfay S.-E., Ljungman C. et al. Differential effects of levosimendan and dobutamine on glomerular filtration rate in patients with heart failure and renal impairment: a randomized double-blind controlled trial. J. Am. Heart Assoc. 2018; 7: e008455. DOI: 10.1161/JAHA.117.008455
  24. Sanfilippo F., Knight J.B., Scolletta S., Santonocito C., Pastore F., Lorini F.L. et al. Levosimendan for patients with severely reduced left ventricular systolic function and/or low cardiac output syndrome undergoing cardiac surgery: a systematic review and meta-analysis. Crit. Care. 2017; 21 (1): 252. DOI: 10.1186/s13054-017-1849-0
  25. Putzu A., Clivio S., Belletti A., Cassina T. Perioperative levosimendan in cardiac surgery: a systematic review with meta-analysis and trial sequential analysis. Int. J. Cardiol. 2018; 251: 22–31. DOI: 10.1016/j.ijcard.2017.10.077
  26. Niu Z.Z., Wu S.M., Sun W.Y., Hou W.M., Chi Y.F. Perioperative levosimendan therapy is associated with a lower incidence of acute kidney injury after cardiac surgery: a meta-analysis. J. Cardiovasc. Pharmacol. 2014; 63 (2): 107–12. DOI: 10.1097/FJC.0000000000000028
  27. Bove T., Matteazzi A., Belletti A., Paternoster G., Saleh O., Taddeo D. et al. Beneficial impact of levosimendan in critically ill patients with or at risk for acute renal failure: a meta-analysis of randomized clinical trials. Heart Lung. Vessel. 2015; 7 (1): 35–46.
  28. Yilmaz M.B., Yalta K., Yontar C., Karadas F., Erdem A., Turgut O.O. et al. Levosimendan improves renal function in patients with acute decompensated heart failure: comparison with dobutamine. Cardiovasc. Drugs Ther. 2007; 21: 431–5. DOI: 10.1007/s10557-007-6066-7
  29. Hou Z.Q., Sun Z.X., Su C.Y., Tan H., Zhong X., Hu B. et al. Effect of levosimendan on estimated glomerular filtration rate in hospitalized patients with decompensated heart failure and renal dysfunction. Cardiovasc. Ther. 2013; 31: 108–14. DOI: 10.1111/1755-5922.12001
  30. Rafouli-Stergiou P., Parissis J.T., Farmakis D., Bistola V., Frogoudaki A., Vasiliadis K. et al. Effects of levosimendan on markers of kidney function in patients with acutely decompensated heart failure and renal impairment. J. Cardiovasc. Med. (Hagerstown). 2015; 31. DOI: 10.2459/JCM.0000000000000244
  31. Zemljic G., Bunc M., Yazdanbakhsh A.P., Vrtovec B. Levosimendan improves renal function in patients with advanced chronic heart failure awaiting cardiac transplantation. J. Card. Fail. 2007; 13: 417–21. DOI: 10.1016/j.cardfail.2007.03.005
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About Authors

  • Akmal Z. Rakhimov, Cand. Med. Sc., Researcher; ORCID
  • Bakht E. Rustamov, Cand. Med. Sc., Researcher; ORCID
  • Sofia D. Pirtskhalava, Cand. Med. Sc., Cardiologist; ORCID
  • El’mira U. Asymbekova, Dr. Med. Sc., Leading Researcher; ORCID

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