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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2011

01-04-2011 | Editorial

Levosimendan: from coronary care to intensive care?

Author: Karen Stuart-Smith

Published in: Intensive Care Medicine | Issue 4/2011

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Excerpt

Numerous multi-centre clinical trials have demonstrated that levosimendan is an effective agent in the management of decompensated heart failure [1]. It has a novel pharmacological profile which makes it particularly suited to improving the performance of the decompensated heart [2]. In the myofilament, levosimendan enhances the sensitivity of troponin C to calcium and stabilizes the Ca2+-troponin C complex [3]. The rate of formation of myosin actin cross bridges is increased, although the rate of dissociation of cross bridges is unaltered, so that there is a greater rate of force development during systole, while diastole is not impaired [4, 5]. Increased contractility is not accompanied by increased cellular metabolism, so that myocardial oxygen consumption is not elevated [1, 3]. There is no effect on heart rate. The inotropic properties of levosimendan are not compromised in the acidotic or hypoxic heart [3]. …
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Bergh CH, Andersson B, Dahlström U, Forfang K, Kivikko M, Sarapohja T, Ullman B, Wikström G (2010) Intravenous levosimendan versus dobutamine in acute decompensated heart failure patients on beta-blockers. Eur J Heart Fail 12:404–410CrossRefPubMed
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Metadata
Title
Levosimendan: from coronary care to intensive care?
Author
Karen Stuart-Smith
Publication date
01-04-2011
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-011-2204-6

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