{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T13:30:06Z","timestamp":1769088606218,"version":"3.49.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1761,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["POCI-01-0145-FEDER-032616"],"award-info":[{"award-number":["POCI-01-0145-FEDER-032616"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Structural and Investment Funds","award":["POCI-01-0145-FEDER-016385"],"award-info":[{"award-number":["POCI-01-0145-FEDER-016385"]}]},{"name":"Norte Portugal Regional Operational Program","award":["NORTE-08-5369-FSE-000024"],"award-info":[{"award-number":["NORTE-08-5369-FSE-000024"]}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["PTDC\/BTM-SAL\/32616\/2017"],"award-info":[{"award-number":["PTDC\/BTM-SAL\/32616\/2017"]}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["SAICT-PAC\/0047\/2015"],"award-info":[{"award-number":["SAICT-PAC\/0047\/2015"]}]},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","award":["UIDB\/00051\/2020"],"award-info":[{"award-number":["UIDB\/00051\/2020"]}]},{"DOI":"10.13039\/501100008530","name":"European Regional Development Fund","doi-asserted-by":"publisher","award":["POCI\u201001\u20100145\u2010FEDER\u2010032616"],"award-info":[{"award-number":["POCI\u201001\u20100145\u2010FEDER\u2010032616"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Assessing reversibility of pulmonary vascular changes through vasoreactivity testing (VRT) optimizes end-stage heart failure patient selection for heart transplant. All efforts should be made to unload the left ventricle and reduce pulmonary vascular resistance to effectively exclude irreversible pulmonary hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We reviewed our centre's cardiac transplant registry database (2009\u20132017) for VRT and compared haemodynamic responses with 40 ppm inhaled NO (n = 14), 14\u201317 \u03bcg inhaled iloprost (n = 7), and 24 h 0.1 \u03bcg\/kg\/min intravenous levosimendan (n = 14). Response to levosimendan was assessed by repeat right heart catheterization within 72 h. Baseline clinical and haemodynamic features were similar between groups. VRT was well tolerated in all patients. All drugs effectively reduced pulmonary artery pressures and transpulmonary gradient while increasing cardiac index, although levosimendan had a greater impact on cardiac index increase (P = 0.036). Levosimendan was the only drug that reduced pulmonary artery wedge pressure (P = 0.004) and central venous pressures (P &amp;lt; 0.001) and increased both left and right ventricular stroke work indexes (P = 0.020 and P = 0.042, respectively) and cardiac power index (P &amp;lt; 0.001) compared with NO and iloprost. Right ventricular end-diastolic pressures and central venous pressure were only decreased by levosimendan. The rate of positive responses (\u226510 mmHg decrease or final mean pulmonary artery pressure \u226440 mmHg with increased\/unaltered cardiac index) was lower with inhaled iloprost (14%) than with either levosimendan or NO (71% and 64%, respectively; P &amp;lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Levosimendan may be a safe and effective alternative for pulmonary hypertension reversibility assessment or a valuable pre-test medical optimization tool in end-stage heart failure patient assessment for heart transplantation offering extended haemodynamic benefits. Whether it increases the rate of positive responses or allows a better selection of candidates to heart transplantation remains to be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13168","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T17:42:04Z","timestamp":1614102124000},"page":"908-917","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of Levosimendan, NO, and Inhaled Iloprost for Pulmonary Hypertension Reversibility Assessment in Heart Transplant Candidates"],"prefix":"10.1093","volume":"8","author":[{"given":"Marta","family":"Tavares-Silva","sequence":"first","affiliation":[{"name":"Department of Cardiology, S\u00e3o Jo\u00e3o Hospital Centre, E.P.E. , Alameda Prof. Hern\u00e2ni Monteiro, Porto, 4200-319 ,","place":["Portugal"]},{"name":"Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto , Porto ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisca","family":"Saraiva","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto , Porto ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Cardiology, S\u00e3o Jo\u00e3o Hospital Centre, E.P.E. , Alameda Prof. Hern\u00e2ni Monteiro, Porto, 4200-319 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Amorim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, S\u00e3o Jo\u00e3o Hospital Centre, E.P.E. , Alameda Prof. Hern\u00e2ni Monteiro, Porto, 4200-319 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o Carlos","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Cardiology, S\u00e3o Jo\u00e3o Hospital Centre, E.P.E. , Alameda Prof. Hern\u00e2ni Monteiro, Porto, 4200-319 ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adelino F.","family":"Leite-Moreira","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto , Porto ,","place":["Portugal"]},{"name":"Department of Cardiothoracic Surgery, S\u00e3o Jo\u00e3o Hospital Centre, E.P.E. , Porto ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J\u00falia","family":"Maciel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, S\u00e3o Jo\u00e3o Hospital Centre, E.P.E. , Alameda Prof. Hern\u00e2ni Monteiro, Porto, 4200-319 ,","place":["Portugal"]},{"name":"Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto , Porto ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9 P.","family":"Louren\u00e7o","sequence":"additional","affiliation":[{"name":"Department of Surgery and Physiology, Cardiovascular R&D Centre, Faculty of Medicine, University of Porto , Porto ,","place":["Portugal"]},{"name":"Department of Anaesthesiology, S\u00e3o Jo\u00e3o Hospital Centre, E.P.E. , Porto ,","place":["Portugal"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"2026012115081037300_ehf213168-bib-0001","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1002\/ejhf.1236","article-title":"Advanced heart failure: a position statement of the Heart Failure Association of the European Society of Cardiology","volume":"20","author":"Crespo-Leiro","year":"2018","journal-title":"Eur J Heart 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