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Treatment of Acute Heart Failure Using Levosimendan for a Patient With Dilated Cardiomyopathy, Chronic Renal Failure, and Hypertension

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Abstract

The clinical and hemodynamic effects of compassionate therapy with levosimendan were evaluated in a 14-year–old patient with end-stage renal disease and arterial hypertension secondary to glycogenosis type Ia. The patient previously had normal heart function but experienced acute development of severe myocardial dysfunction resistant to diuretic therapy and inotropic support. Levosimendan administration was followed by a marked clinical and echocardiographic improvement. The authors believe that levosimendan may be useful for cases of resistant acute heart failure with arterial hypertension. Although administration of levosimendan is not recommended for patients with chronic renal disease, no adverse effect was observed. Therapeutic action for these patients seems to last longer than for patients with a normal kidney.

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Author information

Correspondence to Pablo Lobo Martínez.

Electronic supplementary material

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Movie clip 1: Two-dimensional echocardiogram (apical four-chamber view) before levosimendan administration showing severe left ventricle (LV) systolic dysfunction (LV ejection fraction, 25%). (WMV 1509 kb)

Movie clip 2: Two-dimensional echocardiogram (apical four-chamber view) 24 h after levosimendan initiation showing marked improvement of left ventricle (LV) systolic function (LV ejection fraction, 50%). (WMV 1223 kb)

Movie clip 1: Two-dimensional echocardiogram (apical four-chamber view) before levosimendan administration showing severe left ventricle (LV) systolic dysfunction (LV ejection fraction, 25%). (WMV 1509 kb)

Movie clip 2: Two-dimensional echocardiogram (apical four-chamber view) 24 h after levosimendan initiation showing marked improvement of left ventricle (LV) systolic function (LV ejection fraction, 50%). (WMV 1223 kb)

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Lobo Martínez, P., Oulego Erroz, I., Gautreux Minaya, S. et al. Treatment of Acute Heart Failure Using Levosimendan for a Patient With Dilated Cardiomyopathy, Chronic Renal Failure, and Hypertension. Pediatr Cardiol 32, 1012 (2011) doi:10.1007/s00246-011-0041-6

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Keywords

  • Acute heart failure
  • Glycogenosis type Ia
  • Levosimendan