International journal of cardiology
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Letter Case Reports
The use of Levosimendan for myocardiopathy due to acute Chagas' disease.
Acute Chagas' disease corresponds to the initial period of a Trypanosoma cruzi infection. Levosimendan is a positive inotropic drug with vasodilatory properties that is indicated for acute heart failure. ⋯ Both developed acute decompensated heart failure refractory to Dobutamine. We describe for the first time in the medical literature the use of Levosimendan for myocarditis due to acute Chagas' disease, with excellent clinical and hemodynamic results.
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Randomized Controlled Trial
The use of B-type natriuretic peptide in the management of patients with atrial fibrillation and dyspnea.
The utility of B-type natriuretic peptide (BNP) testing in patients with atrial fibrillation (AF) is poorly defined. We analyzed patients (n=452) included in the BNP for Acute Shortness of Breath Evaluation (BASEL) study. Patients were randomly assigned to a diagnostic strategy with or without the use of BNP. ⋯ Initial total treatment costs (median) were $4239 [769-7422] in the BNP group and $5940 [4024-10848] in the control group (P=0.041). These benefits were maintained after 90 days: patients in the BNP group had spent fewer days in hospital (10 days [2-21] versus 15 days [IQR 9-27]; P=0.022) and induced lower total treatment costs ($4790 [1260-9387] versus $7179 [4311-13173]; P=0.016). In conclusion, the use of BNP seems to improve the management of patients with AF presenting with dyspnea.