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SHR Neuro Cancer Cardio Lipid Metab Microb

Abdelshafy, M; Caliskan, K; Simpkin, AJ; Elkoumy, A; Kimman, JR; Elsherbini, H; Elzomor, H; de By, TMMH; Gollmann-Tepekoylu, C; Berchtold-Herz, M; Loforte, A; Reineke, D; Schoenrath, F; Paluszkiewicz, L; Gummert, J; Mohacsi, P; Meyns, B; Soliman, O.
Efficacy of levosimendan infusion in patients undergoing a left ventricular assist device implant in a propensity score matched analysis of the EUROMACS registry-the Euro LEVO-LVAD study
EUR J CARDIO-THORAC. 2023; 63(5): ezad095 Doi: 10.1093/ejcts/ezad095 [OPEN ACCESS]
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Co-authors Med Uni Graz: Mohacsi Paul
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Abstract:: INTRODUCTION: Early right heart failure (RHF) was seen in 22% of left ventricular assist device (LVAD) recipients in the European registry for patients with mechanical circulatory support (EUROMACS). However, the optimal treatment of post-LVAD RHF is not well known. Levosimendan has proven to be effective in cardiogenic shock patients, and in end-stage heart failure patients. We sought to evaluate the efficacy of levosimendan on post-LVAD RHF and 30-day and 1-year mortality. METHODS: The EUROMACS Registry was used to identify adults with mainstream continuous-flow LVAD implantation treated with preoperative levosimendan compared to a propensity-matched control cohort. RESULTS: In total, 3661 patients received mainstream LVAD, of which 399(11%) were treated with pre-LVAD levosimendan. Levosimendan patients had a higher EUROMACS RHF score [4 (2- 5.5) vs 2 (2- 4); p < 0.001], received more right ventricular assist device (RVAD) [32(8%) vs 178(5.5%); p = 0.038] and stayed longer in the ICU post-LVAD implantation [19 (8- 35) vs 11(5- 25); p < 0.001]. Yet, there was no significant difference in the rate of RHF, 30-day, or 1-year mortality. Also, in the matched cohort (357 levosimendan patients to an average of 622 controls across 20 imputations), we found no evidence for a difference in postoperative severe RHF, RVAD implantation rate, length of ICU stay, or 30-days and 1-year mortality. CONCLUSION: In this analysis of the EUROMACS Registry, we found no evidence for an association between levosimendan and early RHF or mortality, albeit, levosimendan patients had much higher risk profile. For a definitive conclusion, a multicenter, randomised study is warranted.
Find related publications in this database (Keywords): levosimendan; LVAD; Right-sided heart failure; propensity score matching; mechanical circularity support; heart failure