Levosimendan improves diastolic and systolic function in failing human myocardium

Effects of Levosimendan on Left Ventricular Relaxation and Early Filling at Maintained Preload and Afterload Conditions After Aortic Valve Replacement for Aortic Stenosis

“…An absence of calcium sensitization under low prevailing calcium concentrations during diastole would be of critical importance to prevent a worsening of heart failure. The mechanism responsible for the improvement of diastolic function, previously described in experimental in vitro studies 5,6 and demonstrated in the present study, is less understood. It has been shown that levosimendan also exerts a selective inhibition of phosphodiesterase-⌱⌱⌱ activity, particularly in human myocytes, 27,28 which could explain the positive lusitropic effect, especially at higher concentrations.…”

“…In vitro studies have shown that calcium sensitizers (EMD 57033, ORG 30029) may impair myocardial relaxation and elevate diastolic tension in failing human myocardium, 5 whereas levosimendan, on the other hand, has been shown to improve both systolic and diastolic function of cardiac muscle preparations from end-stage failing human hearts. 6 Furthermore, it has recently been suggested that levosimendan improves Doppler echocardiographic variables of LV diastolic function both in patients with severe heart failure 7,8 and in patients with acute myocardial infarction. 9 These findings, however, should be interpreted with caution because these Doppler echocardiographic indexes are preload, afterload, and heart rate dependent.…”

Levosimendan restores the positive force-frequency relation in heart failure

“…Our present observation of the restoration of a positive FFR in HF with levosimendan concurs with several earlier clinical studies that have shown that levosimendan improves the frequency-induced force generation in human failing myocardium (20) and converts a negative FFR into a positive relationship (6,25). However, our observations are somewhat different from those of Givertz et al (16), who studied intracoronary infusion with levosimendan of patients with LV systolic dysfunction and concluded that levosimendan exerts positive inotropic and lusitropic effects over a range of heart rates but does not alter the slope of the FFR or RFR.…”

“…It is well recognized that, in HF, the positive inotropic effects of cAMP-dependent inotropes are attenuated, but Ca 2ϩ sensitizer-produced myofilament Ca 2ϩ sensitization is preserved. Increased experimental studies and clinical data have shown that levosimendan has some advantages over other positive inotropic agents in the treatment of HF (2,6,14,25,40,46,55).…”

CHOICE OF MANAGEMENT METHOD OF MYOCARDIAL REVASCULARIZATION IN PATIENTS WITH LOW LEFT VENTRICULAR EJECTION FRACTION (<35 %): A RANDOMIZED PROSPECTIVE STUDY

“…Применение ВАБК приводит к увеличению сердечного выбро-са, улучшению перфузии коронарных артерий, увеличению доставки кислорода к миокарду, по-вышению среднего артериального давления (САД), снижению постнагрузки, а также снижению конеч-но-диастолического давления в ЛЖ [9][10][11]. Исполь-зование левосимендана при кардиохирургических вмешательствах способствует увеличению силы сердечных сокращений, снижению пред-и пост-нагрузки и улучшает течение послеоперационного периода [12][13][14]. Были доказаны преимущества ис-пользования левосимендана по сравнению с ВАБК у пациентов высокого риска с позиции улучшения гемодинамического профиля, кардиопротекции и уменьшения сроков пребывания в ОРИТ [15].…”