Document Detail

Myocardial efficiency during levosimendan infusion in congestive heart failure.
MedLine Citation:
PMID:  11103755     Owner:  NLM     Status:  MEDLINE    
AIMS: Levosimendan, a novel calcium-dependent calcium sensitizer of the myocardial contractile proteins, also enhances diastolic relaxation and induces peripheral vasodilation by opening potassium channels. To assess the combined energetical effects of levosimendan infusion in vivo, we performed positron emission tomography in patients with decompensated chronic heart failure. METHODS AND RESULTS: Eight hospitalized patients with New York Heart Association functional class III or IV heart failure received levosimendan or placebo intravenously in a randomized double-blind cross-over study. During steady-state, dynamic positron emission tomography with [11C]acetate was used to assess myocardial oxygen consumption and [15O]H2O to measure myocardial blood flow. Cardiac performance and dimensions were assessed by pulmonary artery catheterization and echocardiography. Compared with healthy volunteers, myocardial oxygen consumption during placebo was elevated in the right ventricle but comparable in the left ventricle. During administration of levosimendan, cardiac output increased by 32% (P = .002) mainly because of higher stroke volume. Coronary, pulmonary, and systemic vascular resistance values were significantly reduced. Mean myocardial blood flow increased from 0.76 to 1.02 mL/min/g (P = .033). Levosimendan was neutral on myocardial oxygen consumption and left ventricular efficiency, but it improved right ventricular mechanical efficiency by 24% (P = .012). CONCLUSIONS: Levosimendan has an energetically favorable short-term profile in the treatment of congestive heart failure. It enhances cardiac output without oxygen wasting, particularly by improving efficiency in the right ventricle.
H Ukkonen; M Saraste; J Akkila; J Knuuti; M Karanko; H Iida; P Lehikoinen; K Någren; L Lehtonen; L M Voipio-Pulkki
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical pharmacology and therapeutics     Volume:  68     ISSN:  0009-9236     ISO Abbreviation:  Clin. Pharmacol. Ther.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-22     Completed Date:  2000-12-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372741     Medline TA:  Clin Pharmacol Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  522-31     Citation Subset:  AIM; IM    
Department of Medicine, Turku University Hospital and Turku PET Centre, Finland.
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MeSH Terms
Cardiotonic Agents / administration & dosage,  therapeutic use*
Catheterization, Swan-Ganz
Coronary Vessels / drug effects
Cross-Over Studies
Double-Blind Method
Heart Failure / drug therapy*,  ultrasonography
Hemodynamics / drug effects*
Hydrazones / administration & dosage,  therapeutic use*
Infusions, Intravenous
Middle Aged
Oxygen Consumption / drug effects
Pyridazines / administration & dosage,  therapeutic use*
Tomography, Emission-Computed
Reg. No./Substance:
0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan

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