Intermittent intravenous levosimendan for 6 months reduced mean pulmonary artery pressure from 49.8 to 29.1 mmHg and decreased NT-proBNP by over 30% in a patient with advanced familial dilated cardiomyopathy and post-COVID mixed-type pulmonary hypertension.
Case Report (n=1)
No
Does intermittent intravenous levosimendan improve clinical, hemodynamic, and biomarker outcomes in a patient with advanced heart failure and mixed-type pulmonary hypertension post-COVID-19?
Intermittent intravenous levosimendan may be a beneficial adjunctive therapy for managing intractable congestion and biventricular failure in patients with mixed-type pulmonary hypertension post-COVID-19.
Effect estimate: mPAP reduction from 49.8 to 29.1 mmHg
Absolute Event Rate: 29.1% vs 49.8%
Coronavirus disease-19 infection can exacerbate preexisting chronic heart failure, even after mild illness. This report describes a patient with preexisting dilated cardiomyopathy who developed worsening biventricular failure following recurrent coronavirus disease-19 infections and subsequently improved after intermittent intravenous calcium sensitizer therapy. A 37-year-old Indonesian man with advanced heart failure presented with progressive right ventricular dysfunction and worsening pulmonary hypertension after a second mild coronavirus disease-19 infection. Comprehensive phenotyping and risk stratification were performed using multimodality assessment. The patient received intermittent intravenous levosimendan infusion in addition to optimized guideline-directed medical therapy, resulting in marked clinical, hemodynamic, and biomarker improvement. Managing advanced heart failure with mixed-type pulmonary hypertension. Following coronavirus disease-19 infection remains a complex clinical challenge. This case contributes to the growing evidence supporting the potential role of levosimendan as adjunctive therapy in managing post-coronavirus disease mixed-type pulmonary hypertension with intractable congestion and biventricular failure.
Andryan et al. (Thu,) conducted a case report in 37-year-old Indonesian man with advanced familial dilated cardiomyopathy and worsening biventricular failure with mixed-type pulmonary hypertension following recurrent mild COVID-19 infections despite optimized guideline-directed medical therapy (n=1). Levosimendan intermittent intravenous infusion vs. Optimized guideline-directed medical therapy without levosimendan (baseline) was evaluated on Improvement in pulmonary hypertension parameters, right ventricular function, and NT-proBNP levels after levosimendan infusion (mPAP reduction from 49.8 to 29.1 mmHg). Intermittent intravenous levosimendan for 6 months reduced mean pulmonary artery pressure from 49.8 to 29.1 mmHg and decreased NT-proBNP by over 30% in a patient with advanced familial dilated cardiomyopathy and post-COVID mixed-type pulmonary hypertension.
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