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Home administration of Levosimendan in patients with advanced heart failure – the LEVO-HOME pilot project
Session:
Sessão de Posters 38 - Insuficiência cardíaca avançada
Speaker:
Inês Fialho
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Inês Fialho; Mariana Passos; Filipa Gerardo; Carolina Mateus; Ana Oliveira Soares; David Roque
Abstract
<p style="text-align:justify"><span style="font-size:16px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><strong>Background:</strong> Levosimendan has been used in advanced heart failure (HF) patients in the hospital setting to reduce hospitalizations and improve quality-of-life. However, there is a lack of evidence regarding the safety of its administration at home.</span></span></span></p> <p style="text-align:justify"><span style="color:#000000; font-family:Arial,Helvetica,sans-serif; font-size:16px"><strong>Methods:</strong> We conducted an investigator-initiated</span>,<span style="font-size:16px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"> single-center and non-randomized study involving HF patients with reduced ejection fraction (EF) and NYHA class IV or III with frequent HF decompensations. After an uneventful first hospital administration, Levosimendan was given as a 6-hour infusion, every 2 weeks for 3 months. The primary safety outcome was protocol completion without symptomatic hypotension or dysrhythmias.</span></span></span></p> <p style="text-align:justify"><span style="font-size:16px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><strong>Results:</strong> Eight patients were included, with a median age of 65 (IQR 51 - 75) years; 87.5%, males. The 3-month program was completed by 87.5% (n=7). The median left ventricle EF was 21 [15 - 34] %, and the median NT-proBNP level was 6291 (1673 - 11277) pg/mL. Forty-four administrations were performed, with no symptomatic hypotension or arrythmias. After 3 months, there was a reduction in NYHA class (62.5% improved ≥1 class, p=0.046), HF-related hospitalizations (100% before levosimendan vs 25% after, p=0.016) and NT-proBNP levels (6291 [1673 – 11277] vs 4776 [1229 – 10496 pg/mL], p=0.038). No differences in the treadmill 6-minute walking test (100 [58 – 163] vs 100 [26 – 177], p=0.686) or in the Kansas City Cardiomyopathy Questionnaire (73 [62 – 83] vs 50 [43 – 75], p=0.173) were observed.</span></span></span></p> <p style="text-align:justify"><span style="font-size:16px"><span style="font-family:Arial,Helvetica,sans-serif"><span style="color:#000000"><strong>Conclusions:</strong> Levosimendan proved to be a safe inotrope for at-home use, validating it as a feasible alternative for those who are already receiving intermittent Levosimendan infusions at the hospital.</span></span></span></p>
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