2004, Number 4
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Arch Cardiol Mex 2004; 74 (4)
Usefulness of levosimendan in patients with ventricular dysfunction before surgery
Bauk L, Fiscal LO, Sánchez MG, Gloss AG, López ME, Guillermo Fernández RG
Language: Spanish
References: 20
Page: 295-300
PDF size: 67.72 Kb.
ABSTRACT
The purpose of this work was to observe the hemodynamic stability on the first 24 hours in 4 patients with ventricular dysfunction (Ejected Fraction < 40 %), considered of high surgical risk, in which 24 at 48 hr before the surgery received an infusion of Levosimendan for 24 hours. This 4 patients was male, with age 55.5 ± 7.9 years old, a left ventricle ejection of fraction (LVEF) of 31 ± 5.47%; Two of them was underwent to valve replacement, another one to coronary artery bypass graft and the last one patient underwent combined procedure (coronary artery bypass graft surgery and valve replacement). The behavior of the hemodynamic parameters was stable, without necessity of uses high dose of the inotropics and classic vasopresores in the postoperative.
Conclusion: the Levosimendan could be an inotropic of great application in this group of patient due to its novel action mechanism and to its sustained hemodynamic effects after having finished its infusion.
(Arch Cardiol Mex 2004; 74:295-300).
REFERENCES
Higgins TL, Estefanouse F, Loop FD: Stratification of morbidity and mortality outcome by preoperative risk factors in coronary artery bypass patients. A clinical severity store. JAMA 1992; 267(17): 2344-2348.
Follath F, Cleland G, Just H, Papp JGY, Scholz H, Peuhkurinen K, et al: Efficacy and tolerance of iv Levosimendan comparated with dobutamina in patient with severe low-output heart failure (the LIDO study): a randomized double-blind trial. JAMA 2002; 360: 196-202.
Moiseyer VS, Poder P, Andrejers N, Ruda MY, Golikor AP, Lazebnik LB, et al: Safety and efficacy of novel calcium sensitizer, Levosimendan, in patients with left ventricular failure due ana cute myocardial infarction. A randomized, placebo-controlled, double-blind study. Eur Heart J 2002; 23(18): 1422-32.
Holubarsch C: New inotropic concepts: rationale for and differences between calcium sensibilizers and phosphodiesterase inhibitors. Cardiology 1997; 88(Suppl 2): 12-20.
Sorsa T, Hekkinen S, Abbot MB, Abusamhadneh E, Laakso T, Tilgmann C, et al: Binding of Levosimendan, a calcium sensitizer, to cardiac troponin C. J Biol Chem Commun 2001; 276(12): 9337-43.
Jaquet K, Heilmeyer LMG jr: Influence of association of positive inotropic drugs on calcium binding to cardiac troponin C. Biochem Biophy Res 1987;145: 1390-6.
Lilleberg J, Sundberg S, Nieminen MS: Dose-range study of a new calcium sensitizer, Levosimendan, in patients with left ventricular dysfunction. J Cardiovasc Pharmacol 1995; 26(suppl 1): 63-9.
Lehtonen L: Levosimendan: a promising agent for the treatment of hospitalized patients with descompensated heart failure. Curr Cardiol Rep 2000; 2: 233-43.
Leather HA, Ver Eycken K, Segers P, Heirjgers P, Vandermeersh E, Wounters PF: Effects of Levosimendan on right ventricular function and ventriculovascular coupling in open chest pigs. Crit Care Med 2003; 31: 2339-43.
Lilleberg J, Nieminen MS, Akkila J, Heikkilä L, Kuitunen A, Lehtonen L, et al: Effects of new calcium sensitizer, Levosimendan, on haemodynamics, coronary blood flow and myocardial substrate utilization early after coronary artery bypass grafting. Eur Heart J 1998; 19: 660-8.
Figgitt DP, Gillies PS, Goa KL: Levosimendan. Drugs 2001; 61(5): 613-628.
Singh BN, Lilleberg J, Sandell EP, Ylönen V, Lehtonen L, Toivonen L: Effects of Levosimendan on cardiac arrythmia: electrophysiologic and ambulatory electrocardiographic findings in phase II and phase III clinical studies in cardiac failure. Am J Cardiol 1999; 83(12B): 16(I)-20(I).
Toivonen L, Viitasalo M, Sundberg S, Akkila J, Lehtonen L: Electrophysiologic effects of a calcium sensitizer inotrope Levosimendan administered intravenously in patients with normal cardiac function. J Cardiovasc Pharmacol 2000; 35(4): 664-9.
Bristow MR: Beta adrenergic receptor blockade in chronic heart failure. Circulation 2002; 101: 558-69.
Antila S, Huuskonen H, Nevalainen T, Kanerva H, Vannien P, Lehtonen L: Site dependent bioavailability and metabolism of Levosimendan in dogs. Eur J Pharm Sci 1999; 9(1): 85-91.
Kivikko M, Lehtonen L, Colucci WS: Sustained hemodynamic effects of intravenous Levosimendan. Circulation 2003; 107: 81-6.
Berger RL, Davis KB, Kaiser GC, Foster ED, Hammond GL, Tong TGL, Kennedy JW: Preservation of myocardium during coronary artery bypass grafting. Circulation 1981; 64(Suppl 2): 61-66.
Kennedy JW, Kaiser GC, Fisher LD, Maynard C, Fritz JK, Myers W: Clinical and angiographics predictors of operative mortality from Collaborative Study in Coronary Artery Surgery (CASS). Circulation 1981; 63: 793-802.
Nijhawan N, Nicolosi AC, Montgomery MW, Aggarwal A, Pagel PS, Waltier DC: Levosimendan enhances cardiac performance alter cardiopulmonary bypass: a prospective, randomized placebo-controlled trial. J Cardiovasc Pharmacol 1999; 34(2): 219-28.
Antila S, Eha J, Heinpalu M, Lehtonen L, Loonga I, Mesikepp A, et al: Hemodynamic interactions of new sensitizing drug Levosimendan and captopril. Eur J Clin Pharmacol 1996; 49: 451-8.