Document Detail


Levosimedan improves hemodynamics functions without sympathetic activation in severe heart failure patients: direct evidence from sympathetic neural recording.
MedLine Citation:
PMID:  19929264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Levosimendan is a new inodilatory agent with calcium sensitizing activity. A major concern regarding the use of inotropic agent in heart failure is their effect on the sympathetic tone. This effect could explain increase in short term mortality with other inotropes. We aimed to assess the effect of levosimendan on sympathetic tone measured directly by microneurogra-phy. In a group of acute decompensated heart failure patients, we assessed cardiac performance by digital plethysmography measurement. Sympathetic tone was assessed through recording of muscle sympathetic nerve activity (MSNA) by micro-neurography. Recording were done blindly, for each patient after dobutamine perfusion was stopped (baseline) and 48 h after levosimendan infusion. Clinical, biological and morphological data were collected. We compared cardiac parameters and MSNA before and after administration of levosimendan. 13 patients were recruited (48 +/- 3.6 years). Systolic blood pressure and rate pressure product (mmHg x Beat/min) decreased significantly after levosimendan infusion (P< 0.05). Cardiac output and stroke volume were significantly increased after levosimendan infusion (P< 0.05). A significant decrease of MSNA activity is observed after levosimendan infusion (P< 0.01). Levosimendan induced improvement of cardiac performance, associated with a decreased in MSNA. This study show for the first time that levosimendan has no direct detrimental effect on the sympathetic nervous system.
Authors:
Fabien Despas; Charlotte Trouillet; Nicolas Franchitto; Marc Labrunee; Michel Galinier; Jean-Michel Senard; Atul Pathak
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Acute cardiac care     Volume:  12     ISSN:  1748-295X     ISO Abbreviation:  Acute Card Care     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  25-30     Citation Subset:  IM    
Affiliation:
INSERM U858 ?quipe 8, F-31432 Toulouse, France. fabien.despas@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Cardiotonic Agents / pharmacology,  therapeutic use*
Drug Monitoring / methods
Echocardiography
Electromyography / instrumentation,  methods*
Female
Heart Failure / diagnosis,  drug therapy*,  etiology
Hemodynamics / drug effects*
Humans
Hydrazones / pharmacology,  therapeutic use*
Infusions, Intravenous
Male
Microelectrodes
Middle Aged
Plethysmography
Pyridazines / pharmacology,  therapeutic use*
Single-Blind Method
Statistics, Nonparametric
Sympathetic Nervous System / drug effects*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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