American Heart Journal A randomized controlled trial of levosimendan to reduce mortality in high-risk cardiac surgery patients (CHEETAH): Rationale and design Alberto Zangrillo, MD, Gabriele Alvaro, MD, Antonio Pisano, MD, Fabio Guarracino, MD, Rosetta Lobreglio, MD, Nikola Bradic, MD, Rosalba Lembo, MSc, Stefano Gianni, MD, Maria Grazia Calabrò, MD, Valery Likhvantsev, MD, PhD, Evgeny Grigoryev, MD, Giuseppe Buscaglia, MD, Giovanni Pala, MD, Elisabetta Auci, MD, Bruno Amantea, MD, Fabrizio Monaco, MD, Giovanni De Vuono, MD, Antonio Corcione, MD, Nicola Galdieri, MD, Claudia Cariello, MD, Tiziana Bove, MD, Evgeny Fominskiy, MD, PhD, Stefano Auriemma, MD, Massimo Baiocchi, MD, Alessandro Bianchi, MD, Mario Frontini, MD, Gianluca Paternoster, MD, Fabio Sangalli, MD, Chew-Yin Wang, MB, ChB, Maria Chiara Zucchetti, MD, Giuseppe Biondi-Zoccai, MD, MSc, Marco Gemma, MD, Michael J. Lipinski, MD, PhD, Vladimir V. Lomivorotov, MD, PhD, Giovanni Landoni, MD American Heart Journal Volume 177, Pages 66-73 (July 2016) DOI: 10.1016/j.ahj.2016.03.021 Copyright © 2016 Elsevier Inc. Terms and Conditions
Figure 1 CHEETAH randomization procedure. American Heart Journal 2016 177, 66-73DOI: (10.1016/j.ahj.2016.03.021) Copyright © 2016 Elsevier Inc. Terms and Conditions
Figure 2 Example of study drug titration based on the hemodynamic status. Inotropes (eg, dobutamine), vasoconstrictors (eg, norepinephrine), or epinephrine (that is both an inotrope and a vasoconstrictor) can be used before and after randomization. Volemia optimization occurs at any moment (before and after randomization) in cardiac surgery patients with complicated postoperative course. The suggestion to increase the study drug dose in patients with CI > 2.5 L/(min m2) and MAP >70 mm Hg has the aim to reduce the dose of standard inotropes or vasoconstrictors. MAP, mean arterial pressure; CI, cardiac index. American Heart Journal 2016 177, 66-73DOI: (10.1016/j.ahj.2016.03.021) Copyright © 2016 Elsevier Inc. Terms and Conditions