Levosimendan and Calcium Sensitization of the Contractile Proteins in Cardiac Muscle: Impact on Heart Failure

Levosimendan increases the sensitivity of the cardiac fibrils to calcium, favorably affects hemodynamics in patients with heart failure. It is a positive inotrope and a peripheral vasodilator. The elimination half-life of the compound is about 1 hour. The drug decreases pulmonary capillary wedge pre...

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Bibliographic Details
Published in:Journal of Cardiovascular Pharmacology and Therapeutics 2008-12, Vol.13 (4), p.269-278
Main Authors: Kota, Bindu, Prasad, Aditya S., Economides, Christina, Singh, Bramah N.
Format: Article
Language:English
Subjects:
Calcium - metabolism
Cardiotonic Agents - adverse effects
Cardiotonic Agents - pharmacology
Cardiotonic Agents - therapeutic use
Contractile Proteins - metabolism
Headache - chemically induced
Heart Failure - drug therapy
Heart Failure - metabolism
Heart Failure - physiopathology
Humans
Hydrazones - adverse effects
Hydrazones - pharmacology
Hydrazones - therapeutic use
Hypotension - chemically induced
Myocardium - metabolism
Pyridazines - adverse effects
Pyridazines - pharmacology
Pyridazines - therapeutic use
Randomized Controlled Trials as Topic
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Summary:Levosimendan increases the sensitivity of the cardiac fibrils to calcium, favorably affects hemodynamics in patients with heart failure. It is a positive inotrope and a peripheral vasodilator. The elimination half-life of the compound is about 1 hour. The drug decreases pulmonary capillary wedge pressure, increases cardiac output with the improvement in left ventricular ejection fraction leading to symptomatic improvement which includes decreased dyspnea and fatigue. Levosimendan can be used safely with diuretics, nitrates, beta-blockers, digoxin, and angiotensin-converting enzyme inhibitors. The most common adverse effects of levosimendan are headache and hypotension. Prolongation of the QTc interval does not appear to increase the incidence of arrhythmias, including ventricular tachycardia, ventricular fibrillation, and torsades de pointes. Levosimendan is a novel agent in the treatment of decompensated heart failure, representing a newer class of medications aimed at increasing calcium sensitivity. Its properties holds promise for the treatment of heart failure but further large-scale studies will be needed to determine its precise efficacy, safety, as well as the compound's long-term impact on mortality.
ISSN:1074-2484
1940-4034
DOI:10.1177/1074248408324550