Levosimendan Facilitates Weaning From Cardiopulmonary Bypass in Patients Undergoing Coronary Artery Bypass Grafting With Impaired Left Ventricular Function

Influence of levosimendan on organ dysfunction in patients with severely reduced left ventricular function undergoing cardiac surgery

“…27 Consistent with previous studies, 17,29,30 the present study observed no increased need for vasoconstrictors and significantly reduced demand for epinephrine and nitroglycerine in the levosimendan group. These effects may be due to either the pharmacodynamics and pharmacokinetics of the long-acting agent levosimendan by omitting an initial bolus and using an overall low continuous infusion rate, 31 or to the goal-directed volume administration applied in this study.…”

Levosimendan: The current situation and new prospects

“…49 Levosimendan may have an advantage due to its distinct mechanism of action, enhancing myocardial performance, and offers a promising therapeutic option during off-pump coronary artery bypass grafting (CABG) in patients with normal or impaired myocardial function. 50,51 Although the results are still controversial, most studies on levosimendan in cardiac surgery show a cardioprotective effect, with a decrease in the incidence of low CO syndromes and reduced cardiac troponin release in the postoperative setting that may reduce postoperative mortality. 52---54 It has also been shown that pretreatment with levosimendan in patients undergoing CABG reduces myocardial injury, tracheal intubation time, requirement for inotropic support, and hospital LOS in the intensive care unit.…”

Levosimendan: Molecular mechanisms and clinical implications

“…The latter mechanism is particularly interesting because agonists of mitochondrial ATP-sensitive K + channels appear to confer protection against a variety of potentially lethal stressful conditions [66]. Short-term cardioprotection by levosimendan have been verified by a large number of clinical investigations [67][68][69][70][71][72][73][74], where the effects resembled those observed in experiments mimicking myocardial pre-or postconditioning [75][76][77][78] and/or myocardial stunning [79][80][81]. Longer-term cardioprotection has been also intimated by preclinical studies where levosimendan and/or OR-1896 mitigated cardiomyocyte apoptosis, cardiac remodeling and myocardial inflammation [82][83][84][85][86].…”