Desai Heet N, Sangurima Leslie, Malik Maujid Masood, Ganatra Nency, Siby Rosemary, Kumar Sanjay, Khan Sara, Jayaprakasan Srilakshmi K, Cheriachan Doju, Mohammed Lubna
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Biomedical Sciences, King Faisal University, Alhsa, SAU.
Cureus. 2023 Apr 19;15(4):e37844. doi: 10.7759/cureus.37844. eCollection 2023 Apr.
Levosimendan (LS) has been progressively used for the treatment of patients developing acute as well as chronic or advanced cardiac dysfunction. It has proven to be a better inotropic agent than its counterparts in terms of its ability to increase the cardiac output in an acutely or chronically decompensated heart without an increase in the myocardial oxygen demand. The purpose of this systematic review, which was carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020, was to determine the efficacy and advantages of utilizing LS in patients with both acute and chronic heart failure. We collected and reviewed articles, including clinical trials, literature reviews, randomized and non-randomized control trials, case-control and cohort studies, and systematic reviews and meta-analyses published between January 1, 2012, and November 27, 2022. The databases that were used to collect these articles included Pubmed, Pubmed Central, Cochrane Library, and Google Scholar. After applying appropriate filters, a total of 143 reports were identified from these four databases. They were further screened and subjected to quality assessment tools which finally yielded 21 studies that were included in this systematic review. This review provides strong evidence that the pharmacological properties and different mechanisms of action of LS give it an upper hand over other inotropic agents for its successful administration in patients with either acute or advanced cardiac failure, which consists of left as well as right ventricular failure, either individually or in combination.
左西孟旦（LS）已逐渐用于治疗急性、慢性或晚期心脏功能不全的患者。事实证明，就其在急性或慢性失代偿性心脏中增加心输出量而不增加心肌需氧量的能力而言，它是一种比同类药物更好的正性肌力药物。本系统评价按照《系统评价和Meta分析的首选报告项目》（PRISMA）2020进行，目的是确定在急性和慢性心力衰竭患者中使用LS的疗效和优势。我们收集并审查了2012年1月1日至2022年11月27日期间发表的文章，包括临床试验、文献综述、随机和非随机对照试验、病例对照和队列研究以及系统评价和Meta分析。用于收集这些文章的数据库包括PubMed、PubMed Central、Cochrane图书馆和谷歌学术。应用适当的筛选条件后，从这四个数据库中总共识别出143份报告。它们经过进一步筛选并接受质量评估工具评估，最终有21项研究纳入本系统评价。本评价提供了有力证据，表明LS的药理特性和不同作用机制使其在急性或晚期心力衰竭患者（包括单独或联合出现的左心室和右心室衰竭）的成功给药方面优于其他正性肌力药物。
