| Hemodynamic improvement following levosimendan treatment in patients with acute myocardial infarction and cardiogenic shock. | |
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MedLine Citation:
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PMID: 17893627 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Levosimendan, a novel inodilator, has been shown to improve hemodynamic function in patients with acute exacerbation of congestive heart failure. We wanted to determine the hemodynamic effects of levosimendan following ineffective conventional therapy (with catecholamines) in patients with cardiogenic shock following myocardial infarction. DESIGN: Observational hemodynamic study. SETTING: Tertiary care center university hospital. PATIENTS: Fifty-six patients with cardiogenic shock secondary to myocardial infarction were treated with percutaneous revascularization (intra-aortic balloon pump where appropriate) and commenced on conventional inotropic therapy. INTERVENTIONS: Patients with persisting cardiogenic shock 24 hrs after revascularization were additionally treated with levosimendan (rapid bolus of 12 microg/kg for 10 mins, then 0.05-0.2 mug/kg/min for 24 hrs) (n = 25). MEASUREMENTS AND MAIN RESULTS: With conventional catecholamine therapy (norepinephrine and dobutamine), we observed only marginal improvement in mean arterial pressure or cardiac index. In contrast, the addition of levosimendan produced a significant increase in cardiac index (2.1 +/- 0.56 to 3.0 +/- 1.11 L/min/m2, p < .01) and cardiac power index (0.32 +/- 0.08 to 0.44 +/- 0.18 W, p < .01), whereas systemic vascular resistance decreased significantly (1208 +/- 333 to 858 +/- 299 dyne.sec.cm(-5), p < .01). There was no significant change in blood pressure during levosimendan treatment. Hemodynamic improvement was sustained after levosimendan infusion was stopped. CONCLUSIONS: Levosimendan infusion in cardiogenic shock following acute myocardial infarction improved cardiovascular hemodynamics without leading to hypotension. |
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Authors:
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Martin A Russ; Roland Prondzinsky; Arnd Christoph; Axel Schlitt; Ute Buerke; Gerold Söffker; Henning Lemm; Michael Swyter; Nikolas Wegener; Matthias Winkler; Justin M Carter; Sebastian Reith; Karl Werdan; Michael Buerke |
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Publication Detail:
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Type: Clinical Trial; Comment; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 35 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-28 Completed Date: 2007-12-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2732-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine III, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary Cardiotonic Agents / adverse effects, pharmacology*, therapeutic use Catecholamines / pharmacology, therapeutic use Dobutamine / pharmacology, therapeutic use Female Hemodynamics / drug effects* Humans Hydrazones / adverse effects, pharmacology*, therapeutic use Infusions, Intravenous Male Middle Aged Pyridazines / adverse effects, pharmacology*, therapeutic use Shock, Cardiogenic / drug therapy*, therapy |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 0/Catecholamines; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan; 34368-04-2/Dobutamine |
| Comments/Corrections | |
Comment On:
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Crit Care Med. 2007 Dec;35(12):2862-4
[PMID:
18043208
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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