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Intermittent inotropic therapy with levosimendan vs milrinone in advanced heart failure patients

ESC Heart Failure Feb 01, 2022

In ambulatory advanced heart failure (HF) patients, switching from milrinone to levosimendan based intermittent inotropic therapy (IIT) resulted in improvements in right ventricular systolic function, maximal O <sub>2</sub> consumption, and B-natriuretic peptide (BNP).

  • In this single-center small-scale study, consecutive ambulatory advanced HF patients that received ≥4 cycles of once-weekly milrinone IIT, who were switched to levosimendan IIT, were included.

  • The cohort comprised 11 patients, 10 (91%) were male and the mean age was 76 ± 12 years.

  • After 4 weeks of levosimendan therapy, improvement in maximal O <sub>2</sub> consumption by a mean of 2.28 mL/kg occurred in 8/9 (89%) patients.

  • A total of 9/11 (82%) levosimendan treated patients showed reduction in BNP levels, from a median of 1015 ng/L [261–1035] to 719 ng/L [294–739].

  • Improvement in quality of life was seen in 8/11 (82%) patients after levosimendan IIT.

  • Increase in peak systolic annular velocity on echocardiography by an average of 3 cm/s was evident after levosimendan IIT.

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