Levosimendana em pacientes com insuficiência cardíaca descompensada: eficácia em uma coorte brasileira. Resultados do estudo BELIEF
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Data
2008
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Background: Levosimendan is a new inodilatory agent that enhances cardiac contractility via Ca(2+) sensitization and induces vasodilation
through the activation of KATP/BKCa.
Objective: To study the efficacy and safety of levosimendan in a decompensated heart failure (DHF) Brazilian cohort, and in β-adrenergic
agonist resistant patients.
Methods: The Brazilian Evaluation of Levosimendan Infusion Efficacy (BELIEF) study was prospective, multicenter, observational and included
182 high-risk DHF patients, all of which received open-label levosimendan. Primary end point was hospital discharge without additional
inotropic therapy (responder). Secondary end points were changes in hemodynamics, clinical parameters, and brain natriuretic peptide (BNP).
Results: Mortality rate was 14.8%, and 139 of 182 patients were responders. In non responders it was 62.8%. Systolic blood pressure was a
predictor of response. In β-adrenergic agonist resistant group, 55.8% were responders. Overall, 54 patients experienced at least one adverse
event; most of them resolved either spontaneously or after levosimendan dose reduction. A significant improvement in quality of life was verified
at 2-6 months of follow-up (p<0.0001).
Conclusion: Our results suggest levosimendan infusion as an alternative therapy in the short term management of DHF patients. HF severity
can influence the response to levosimendan treatment. Prospective studies are warranted in a Brazilian cohort including Chagas heart disease.
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Baixo débito cardíaco, Agentes inotrópicos cardíaco-positivo, Levosimendana, Pressão arterial, Insuficiência cardíaca congestiva, Doença de chagas, Dispnéia, Heart failure, Decompensated heart failure, Levosimendan, Inotropic drug, Decompensated congestive heart failure, dyspnea, Chagas disease, systolic blood pressure
Citação
BOCCHI, Edimar Alcides et al. Levosimendana em pacientes com insuficiência cardíaca descompensada: eficácia em uma coorte brasileira. Resultados do estudo BELIEF. Arquivos Brasileiros de Cardiologia, São Paulo, v. 90, n. 3, p. 2001-2010, 2008.