Effects of repeated administration of Levosimendan in advanced heart failure in the elderly patient

Abstract Introduction Advanced heart failure (AHF) is characterized by repeated episodes of hemodynamic instability, frequent hospitalizations with progressive reduction in quality life. The aim the study was to verify a small group patients, no longer susceptible transplantation (HT) and left ventricular assistance (LVAD), effectiveness monthly treatment Levosimendan for period at least 6 months on life hospitalization. Materials methods 29 elderly patients (≥65 years) AHF, excluded from waiting list HT or eligible inclusion were enrolled. 12 practiced 1 infusion considered as cases, while 17 maximized used controls. All underwent multidimensional evaluation which Fraity assessed according Fried criteria, cognitive function Mini-Mental State Examination (MMSE), depressive symptoms Geriatric Depression Scale (GDS). Results followed up an average 4.6±2.7 infusions absence adverse events. mean age 73.3±6.2, 87.5% males, NYHA class 3.4±0.4, ejection fraction 26.6±4.9 NT-pro-BNP value 7016.8±4876.1. Renal impaired eGFR (ml / min) = 36.8±20.1. These had been hospitalized 1.8±0.7 times previous year. data are not statistically different compared control although greater severity clinical condition case evident. minute walking test (6MWT) 201.4±118.1 meters. values Frailty 4.6±0.5, GDS 6.4±4.2 MMSE 23.8±4.3. Only lower than controls (26.9±1.9, p=0.022). results terms pre-post difference identify improvement 35.3±136.3 meters 6MWT treated −72.2±94.2 (p=0.030), reduced 1.4±1.6 points 0.1±1.1 decreases 0.9±1.5 cases increases 2±2.1 (p=0.020), score 2.12±4.1 it 2.75±2.3 group; p=0.003. both groups more (−1.87±5.8 vs −10.8±11.1; p=0.043). There significant differences mortality there less hospitalization during follow-up 0.9±0.6 2.4±1.5; p=0.016). Multiple regression analysis shows that correlated recovery frailty. This association independent disease severity. Conclusion improves physical function, same time minor decrease renal observed, unscheduled visits hospital. Funding Acknowledgement Type funding sources: None.