Pathological interplay between the heart and kidneys-also known as cardio-renal syndrome (CRS)-is frequently encountered in heart failure and is linked to worse prognosis and quality of life. Drug therapies for this complex situation may include nitroprusside or the recombinant B-type natriuretic peptide nesiritide for patients with acute CRS with normal or high blood pressure, and inotropes or inodilators for patients with acute CRS with low blood pressure. Clinical data for a renal-protective action of levosimendan are suggestive, and meta-analysis data obtained in a range of low-output states are consistent with a levosimendan-induced benefit. Evidence of favourable organ-specific effects of levosimendan, including pre-glomerular vasodilation and increased renal artery diameter and renal blood flow, were collected both in preclinical and clinical studies. Larger randomized controlled trials are however needed to confirm the renal effects of levosimendan in various clinical settings.

Pharmacological approaches to cardio-renal syndrome. a role for the inodilator levosimendan / Fedele, Francesco; Karason, Kristjan; Matskeplishvili, Simon. - In: EUROPEAN HEART JOURNAL SUPPLEMENTS. - ISSN 1520-765X. - ELETTRONICO. - 19:Suppl C(2017), pp. C22-C28. [10.1093/eurheartj/sux002]

Pharmacological approaches to cardio-renal syndrome. a role for the inodilator levosimendan

Fedele, Francesco
;
2017

Abstract

Pathological interplay between the heart and kidneys-also known as cardio-renal syndrome (CRS)-is frequently encountered in heart failure and is linked to worse prognosis and quality of life. Drug therapies for this complex situation may include nitroprusside or the recombinant B-type natriuretic peptide nesiritide for patients with acute CRS with normal or high blood pressure, and inotropes or inodilators for patients with acute CRS with low blood pressure. Clinical data for a renal-protective action of levosimendan are suggestive, and meta-analysis data obtained in a range of low-output states are consistent with a levosimendan-induced benefit. Evidence of favourable organ-specific effects of levosimendan, including pre-glomerular vasodilation and increased renal artery diameter and renal blood flow, were collected both in preclinical and clinical studies. Larger randomized controlled trials are however needed to confirm the renal effects of levosimendan in various clinical settings.
2017
Acute heart failure; advanced heart failure; cardio-renal syndrome; kidney; levosimendan; cardiology and cardiovascular medicine
01 Pubblicazione su rivista::01a Articolo in rivista
Pharmacological approaches to cardio-renal syndrome. a role for the inodilator levosimendan / Fedele, Francesco; Karason, Kristjan; Matskeplishvili, Simon. - In: EUROPEAN HEART JOURNAL SUPPLEMENTS. - ISSN 1520-765X. - ELETTRONICO. - 19:Suppl C(2017), pp. C22-C28. [10.1093/eurheartj/sux002]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1148774
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