Document Detail

The calcium sensitizer levosimendan improves the function of stunned myocardium after percutaneous transluminal coronary angioplasty in acute myocardial ischemia.
MedLine Citation:
PMID:  15193677     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We assessed the effects of levosimendan on left ventricular (LV) function in patients with acute myocardial ischemia and after coronary angioplasty. BACKGROUND: The calcium sensitizer levosimendan improves the function of myocardium in experimental stunning. METHODS: Twenty-four patients with an acute coronary syndrome underwent angioplasty followed by double-blinded, randomized treatment with 24 microg/kg of levosimendan (n = 16) or placebo (n = 8). Left ventricular pressures and volumes were recorded by cineventriculography and micromanometer-tipped catheters 10 min after angioplasty before drug administration (baseline) and 20 min after drug administration. Left ventricular function was assessed by the pressure-volume loop, and regional function analysis by the Slager method. RESULTS: The number of hypokinetic segments decreased with levosimendan, from 8.9 +/- 0.9 to 6.5 +/- 1.1 (mean +/- SEM), as compared with an increase from 7.8 +/- 1.0 to 8.5 +/- 1.1 with placebo (p = 0.016). A leftward and/or upward shift of the systolic part of the pressure-volume loop, indicating improved systolic function, was observed in eight of 16 of the levosimendan-treated and one of eight of the placebo patients (p = 0.178). In addition, the single-beat elastance was increased by levosimendan (p = 0.045). The pressure-volume area (p = 0.001), end-systolic pressure (p = 0.002), and volume index (p < 0.001) were decreased by levosimendan, but there was no change in the end-systolic pressure-volume ratio. End-diastolic pressure remained unchanged, whereas the end-diastolic volume index was decreased by levosimendan (p = 0.002). The time constant of isovolumic LV pressure fall decreased with levosimendan (p = 0.001). CONCLUSIONS: Levosimendan improved the function of stunned myocardium without obvious impairment of diastolic function.
Steffen Sonntag; Stig Sundberg; Lasse Antero Lehtonen; Franz Xaver Kleber
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  43     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-14     Completed Date:  2004-07-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2177-82     Citation Subset:  AIM; IM    
Department of Internal Medicine, UKB Berlin, Academic Teaching Hospital, Free University Berlin, Berlin, Germany.
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MeSH Terms
Acute Disease
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary*
Cardiac Volume / drug effects
Cardiotonic Agents / therapeutic use*
Coronary Circulation / drug effects
Coronary Disease / physiopathology,  therapy
Diastole / drug effects
Double-Blind Method
Hydrazones / therapeutic use*
Middle Aged
Myocardial Ischemia / physiopathology*,  therapy*
Myocardial Stunning / physiopathology,  therapy
Pyridazines / therapeutic use*
Systole / drug effects
Treatment Outcome
Vasodilation / drug effects
Vasodilator Agents / therapeutic use*
Ventricular Function, Left / drug effects
Ventricular Pressure / drug effects
Reg. No./Substance:
0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 0/Vasodilator Agents; 131741-08-7/simendan

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

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