{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:12:23Z","timestamp":1790827943926,"version":"4.1.0"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"Supplement_D","license":[{"start":{"date-parts":[[2020,5,15]],"date-time":"2020-05-15T00:00:00Z","timestamp":1589500800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Orion Pharma"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Pathological interplay between the heart and kidneys is widely encountered in heart failure (HF) and is linked to worse prognosis and quality of life. Inotropes, along with diuretics and vasodilators, are a core medical response to HF but decompensated patients who need inotropic support often present with an acute worsening of renal function. The impact of inotropes on renal function is thus potentially an important influence on the choice of therapy. There is currently relatively little objective data available to guide the selection of inotrope therapy but recent direct observations on the effects of levosimendan and milrinone on glomerular filtration favour levosimendan. Other lines of evidence indicate that in acute decompensated HF levosimendan has an immediate renoprotective effect by increasing renal blood flow through preferential vasodilation of the renal afferent arterioles and increases in glomerular filtration rate: potential for renal medullary ischaemia is avoided by an offsetting increase in renal oxygen delivery. These indications of a putative reno-protective action of levosimendan support the view that this calcium-sensitizing inodilator may be preferable to dobutamine or other adrenergic inotropes in some settings by virtue of its renal effects. Additional large studies will be required, however, to clarify the renal effects of levosimendan in this and other relevant clinical situations, such as cardiac surgery.<\/jats:p>","DOI":"10.1093\/eurheartj\/suaa091","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T13:22:16Z","timestamp":1594992136000},"page":"D12-D19","source":"Crossref","is-referenced-by-count":18,"title":["Differential effects of inotropes and inodilators on renal function in acute cardiac care"],"prefix":"10.1093","volume":"22","author":[{"given":"Endre","family":"Zima","sequence":"first","affiliation":[{"name":"Cardiac Intensive Care, Heart and Vascular Center, Semmelweis University, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Farmakis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Cyprus Medical School, Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Pollesello","sequence":"additional","affiliation":[{"name":"Critical Care Proprietary Products, CO, Orion Pharma, PO Box 65, FIN-02101 Espoo, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T","family":"Parissis","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, National and Kapodistrian University of Athens, Attikon General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,15]]},"reference":[{"key":"2020071623442985600_suaa091-B1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1093\/eurheartj\/eht386","article-title":"Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta-analysis","volume":"35","author":"Damman","year":"2014","journal-title":"Eur Heart J"},{"key":"2020071623442985600_suaa091-B2","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1016\/j.jacc.2005.11.084","article-title":"Renal impairment and outcomes in heart failure: systematic review and meta-analysis","volume":"47","author":"Smith","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"2020071623442985600_suaa091-B3","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1159\/000099012","article-title":"Risk for acute renal failure in patients hospitalized for decompensated congestive heart failure","volume":"27","author":"Chittineni","year":"2007","journal-title":"Am J Nephrol"},{"key":"2020071623442985600_suaa091-B4","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1093\/eurjhf\/hfp108","article-title":"; COACH investigators. 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