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<< Acute Decompensated Heart Failure: New Strategies for Improving Outcomes (Pharmacology CME)

Controversies and Cutting Edge

Novel Drug Therapies

Levosimendan

Levosimendan is a new medication being studied that is considered a “calcium-sensitizer,” and is infused intravenously. It has been approved for use in Europe, but not yet in the United States. Levosimendan works by increasing myocardial contractility by sensitizing the cardiac myocytes to calcium and causing vasodilatation. In the REVIVE study that examined 600 patients with ADHF, levosimendan, when added to standard therapy, resulted in a more rapid symptomatic improvement when compared to placebo with standard therapy; however, there was an increased risk of hypotension and dysrhythmias associated with its administration.88 This study was funded by the drug manufacturer, and subsequent studies have not demonstrated improvement in mortality or rehospitalization when levosimendan was compared to dobutamine.89-91

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