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Levosimendan

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https://www.readbyqxmd.com/read/27914501/levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-on-cardiopulmonary-bypass-rationale-and-study-design-of-the-levosimendan-in-patients-with-left-ventricular-systolic-dysfunction-undergoing-cardiac-surgery-requiring
#1
Rajendra H Mehta, Sean Van Diepen, James Meza, Paula Bokesch, Jeffrey D Leimberger, Sandra Tourt-Uhlig, Merri Swartz, Jodi Parrotta, Rachael Jankowich, Douglas Hay, Robert W Harrison, Stephen Fremes, Shaun G Goodman, John Luber, Wolfgang Toller, Matthias Heringlake, Kevin J Anstrom, Jerrold H Levy, Robert A Harrington, John H Alexander
BACKGROUND: Low cardiac output syndrome is associated with increased mortality and occurs in 3% to 14% of patients undergoing cardiac surgery on cardiopulmonary bypass (CPB). Levosimendan, a novel calcium sensitizer and KATP channel activator with inotropic, vasodilatory, and cardioprotective properties, has shown significant promise in reducing the incidence of low cardiac output syndrome and related adverse outcomes in patients undergoing cardiac surgery on CPB. METHODS: LEVO-CTS is a phase 3 randomized, controlled, multicenter study evaluating the efficacy, safety, and cost-effectiveness of levosimendan in reducing morbidity and mortality in high-risk patients with reduced left ventricular ejection fraction (≤35%) undergoing cardiac surgery on CPB...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27910084/levosimendan-accelerates-recovery-in-patients-with-takotsubo-cardiomyopathy
#2
Mehmet Yaman, Ugur Arslan, Ahmet Kaya, Aytac Akyol, Fatih Ozturk, Yunus Emre Okudan, Adil Bayramoglu, Osman Bektas
BACKGROUND: The aim of this study was to determine the efficacy and safety of levosimendan in takotsubo cardiomyopathy (TC). METHODS: The study was conducted in a retrospective design and 42 consecutive patients were enrolled in 6 cardiovascular centers in Turkey. The records of TC patients having left ventricular ejection fraction (LVEF) ≤ 35% were examined at admission, discharge and recovery period including their clinical and echocardiographic data were recorded...
December 2, 2016: Cardiology Journal
https://www.readbyqxmd.com/read/27906091/impact-of-prophylactic-administration-of-levosimendan-on-short-term-and-long-term-outcome-in-high-risk-patients-with-severely-reduced-left-ventricular-ejection-fraction-undergoing-cardiac-surgery-a-retrospective-analysis
#3
Philippe Grieshaber, Stella Lipp, Andreas Arnold, Gerold Görlach, Matthias Wollbrück, Peter Roth, Bernd Niemann, Jochen Wilhelm, Andreas Böning
BACKGROUND: Patients with severely reduced left-ventricular ejection fraction carry a high risk of morbidity and mortality after cardiac surgery. Levosimendan can be used prophylactically in these patients having shown positive effects on short-term outcome. However, effects on long-term outcome and patient subgroups benefiting the most are unknown. We aim to address these topics with real-life data from our clinical practice. METHODS: Two hundred eigthy eight patients with preoperative LVEF ≤ 35% underwent cardiac surgery with cardiopulmonary bypass between 2009 and 2013...
December 1, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#4
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27875737/experimental-evidence-for-a-severe-proarrhythmic-potential-of-levosimendan
#5
Gerrit Frommeyer, Anja Kohnke, Christian Ellermann, Dirk G Dechering, Simon Kochhäuser, Christian Pott, Michael Fehr, Lars Eckardt
BACKGROUND: The calcium sensitizer levosimendan is established for therapy of acutely decompensated congestive heart failure. Clinical experience suggests a possible proarrhythmic potential. The aim of the present study was to assess possible proarrhythmic effects and underlying electrophysiological mechanisms. METHODS AND RESULTS: Ten rabbit hearts were isolated and Langendorff-perfused. Thereafter, levosimendan was infused in 3 concentrations (0.5, 1, and 2μM)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27851890/levosimendan-exerts-anticonvulsant-properties-against-ptz-induced-seizures-in-mice-through-activation-of-nnos-no-pathway-role-for-katp-channel
#6
Maziar Gooshe, Mohammad Tabaeizadeh, Ali Reza Aleyasin, Payam Mojahedi, Keyvan Ghasemi, Farbod Yousefi, Ali Vafaei, Hossein Amini Khoyi, Shayan Amiri, Ahmad Reza Dehpour
AIMS: Although approving new anticonvulsants was a major breakthrough in the field of epilepsy control, so far we have met limited success in almost one third of patients suffering from epilepsy and a definite and reliable method is yet to be found. Levosimendan demonstrated neuroprotective effects and reduced mortality in conditions in which seizure can be an etiology of death; however, the underlying neuroprotective mechanisms of levosimendan still eludes us. In the light of evidence suggesting levosimendan can be a KATP channel opener and nitrergic pathway activator, levosimendan may exert antiseizure effects through KATP channels and nitrergic pathway...
November 13, 2016: Life Sciences
https://www.readbyqxmd.com/read/27850949/1313-levosimendan-improved-renal-function-in-pediatric-patients-with-decompensated-heart-failure
#7
Alyaa Al Ali, Musaab Ramsi
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27801307/pregnancy-related-cardiovascular-complications-case-presentation-and-review-of-literature
#8
Hasan Baki Altinsoy, Ozkan Alatas, Salih Colak, Hakan Atalay, Omer Faruk Dogan
BACKGROUND: Cardiovascular complications that can cause severe catastrophic outcomes for both the mother and the fetus are rarely seen during pregnancy. Time to diagnosis is often delayed by a low degree of suspicion and atypical presentation. We report surgical strategies in three pregnant women with cardiovascular complications. METHODS: A retrospective search from 2009 to 2016 identified three pregnant women who underwent urgent cardiac surgery. We used extracorporeal circulation (ECC) without cesarean section with careful follow-up of the fetuses during the perioperative and postoperative period...
October 31, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27801303/levosimendan-use-increases-cardiac-performance-after-coronary-artery-bypass-grafting-in-end-stage-renal-disease-patients
#9
Hakan Atalay, Zeki Temizturk, Hasan Baki Altinsoy, Davut Azboy, Salih Colak, Atakan Atalay, Omer Faruk Dogan
BACKGROUND: The effect of levosimendan on myocardial performance has not been studied in dialysis-dependent end-stage renal disease patients who have undergone coronary artery bypass grafting (CABG) surgery. Our aim was to investigate the effect of levosimendan on postoperative hemodynamic effects in end-stage renal disease patients undergoing CABG operation. METHODS: We performed 58 elective isolated CABG operations in end-stage renal disease patients. The study group received levosimendan at a slow bolus dose of 3 µg/kg, followed by a 24-hour infusion of 0...
October 27, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27793852/acute-exposure-to-progesterone-attenuates-cardiac-contraction-by-modifying-myofilament-calcium-sensitivity-in-the-female-mouse-heart
#10
Hirad A Feridooni, Jennifer K MacDonald, Anjali Ghimire, W Glen Pyle, Susan E Howlett
Acute application of progesterone attenuates cardiac contraction, although the underlying mechanisms are unclear. We investigated whether progesterone modified contraction in isolated ventricular myocytes and identified the Ca(2+) handling mechanisms involved in female C57BL/6 mice (6-9 mos; sodium pentobarbital anesthesia). Cells were field-stimulated (4 Hz; 37°C) and exposed to progesterone (0.001-10.0 μM) or vehicle (35 mins). Ca(2+) transients (fura-2) and cell shortening were recorded simultaneously...
October 28, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27778514/advanced-heart-failure-an-appraisal-of-the-potential-of-levosimendan-in-this-end-stage-scenario-and-some-related-ethical-considerations
#11
Sonja Fruhwald, Piero Pollesello, Friedrich Fruhwald
The later stages of heart failure are characterized by a steady decline in quality of life. Clinical priorities should be to maintain functional capacity and quality of life. In the absence of sufficient organs for transplantation, options include left ventricular assist devices and inotropic support. Areas covered: We examined data published in the last two decades on the use of inotropes and inodilators in advanced heart failure. Expert commentary: In the literature, use of conventional inotropes, including adrenergic agonists and phosphodiesterase inhibitors, appears to be suboptimal for achieving the clinical priorities of late-stage heart failure...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27760984/the-worsening-renal-failure-in-a-chronic-cardio-renal-syndrome-type-ii-efficacy-of-a-single-levosimendan-infusion
#12
Cinzia Ferreri, Marzia Testa, Laura Leto, Mauro Feola
No abstract text is available yet for this article.
December 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27720291/impact-of-milrinone-administration-in-adult-cardiac-surgery-patients-updated-meta-analysis
#13
Masahiro Ushio, Moritoki Egi, Junji Wakabayashi, Taichi Nishimura, Yuji Miyatake, Norihiko Obata, Satoshi Mizobuchi
OBJECTIVE: To determine the effects of milrinone on short-term mortality in cardiac surgery patients with focus on the presence or absence of heterogeneity of the effect. DESIGN: A systematic review and meta-analysis. SETTING AND PARTICIPANTS: Five hundred thirty-seven adult cardiac surgery patients from 12 RCTs. INTERVENTIONS: Milrinone administration. MEASUREMENTS AND MAIN RESULTS: The authors conducted a systematic Medline and Pubmed search to assess the effect of milrinone on short-term mortality in adult cardiac surgery patients...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27713891/vasoactive-agents-for-the-treatment-of-sepsis
#14
Zhongheng Zhang, Kun Chen
The article describes some commonly used vasoactive agents in patients with septic shock. Depending on their distinct pharmacological properties, their effects on vascular bed and cardiac function are different. For example, dopamine has equivalent effect on heart and vasculature, which can result in increases in cardiac output, mean arterial pressure and heart rate. Dobutamine is considered as inodilator because it has potent effect on cardiac systole and vasculature. Patients with sepsis and septic shock sometimes have coexisting cardiac dysfunction that justifies the use of dobutamine...
September 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/27705084/levosimendan-for-the-prevention-of-acute-organ-dysfunction-in-sepsis
#15
Anthony C Gordon, Gavin D Perkins, Mervyn Singer, Daniel F McAuley, Robert M L Orme, Shalini Santhakumaran, Alexina J Mason, Mary Cross, Farah Al-Beidh, Janis Best-Lane, David Brealey, Christopher L Nutt, James J McNamee, Henrik Reschreiter, Andrew Breen, Kathleen D Liu, Deborah Ashby
Background Levosimendan is a calcium-sensitizing drug with inotropic and other properties that may improve outcomes in patients with sepsis. Methods We conducted a double-blind, randomized clinical trial to investigate whether levosimendan reduces the severity of organ dysfunction in adults with sepsis. Patients were randomly assigned to receive a blinded infusion of levosimendan (at a dose of 0.05 to 0.2 μg per kilogram of body weight per minute) for 24 hours or placebo in addition to standard care. The primary outcome was the mean daily Sequential Organ Failure Assessment (SOFA) score in the intensive care unit up to day 28 (scores for each of five systems range from 0 to 4, with higher scores indicating more severe dysfunction; maximum score, 20)...
October 5, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27703584/the-role-of-levosimendan-in-patients-with-decreased-left-ventricular-function-undergoing-cardiac-surgery
#16
Marija Bozhinovska, Gordana Taleska, Andrej Fabian, Maja Šoštarič
The postoperative low cardiac output is one of the most important complications following cardiac surgery and is associated with increased morbidity and mortality. The condition requires inotropic support to achieve adequate hemodynamic status and tissue perfusion. While catecholamines are utilised as a standard therapy in cardiac surgery, their use is limited due to increased oxygen consumption. Levosimendan is calcium sensitising inodilatator expressing positive inotropic effect by binding with cardiac troponin C without increasing oxygen demand...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27698733/role-of-picco-monitoring-for-the-integrated-management-of-neurogenic-pulmonary-edema-following-traumatic-brain-injury-a-case-report-and-literature-review
#17
Xiaoping Lin, Zhijun Xu, Pengfei Wang, Yan Xu, Gensheng Zhang
Neurogenic pulmonary edema (NPE) is occasionally observed in patients with traumatic brain injury (TBI); however, this condition is often underappreciated. NPE is frequently misdiagnosed due to its atypical clinical performance, thus delaying appropriate treatment. A comprehensive management protocol of NPE in patients with TBI has yet to be established. The current study reported the case of a 67-year-old man with severe TBI who was transferred to our intensive care unit (ICU). On day 7 after hospitalization, the patient suddenly suffered tachypnea, tachycardia, systemic hypertension and hypoxemia during lumbar cistern drainage...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27693206/randomized-evidence-for-reduction-of-perioperative-mortality-an-updated-consensus-process
#18
Giovanni Landoni, Antonio Pisano, Vladimir Lomivorotov, Gabriele Alvaro, Ludhmila Hajjar, Gianluca Paternoster, Caetano Nigro Neto, Nicola Latronico, Evgeny Fominskiy, Laura Pasin, Gabriele Finco, Rosetta Lobreglio, Maria Luisa Azzolini, Giuseppe Buscaglia, Alberto Castella, Marco Comis, Adele Conte, Massimiliano Conte, Francesco Corradi, Erika Dal Checco, Giovanni De Vuono, Marco Ganzaroli, Eugenio Garofalo, Gordana Gazivoda, Rosalba Lembo, Daniele Marianello, Martina Baiardo Redaelli, Fabrizio Monaco, Valentina Tarzia, Marta Mucchetti, Alessandro Belletti, Paolo Mura, Mario Musu, Giovanni Pala, Massimiliano Paltenghi, Vadim Pasyuga, Desiderio Piras, Claudio Riefolo, Agostino Roasio, Laura Ruggeri, Francesco Santini, Andrea Székely, Luigi Verniero, Antonella Vezzani, Alberto Zangrillo, Rinaldo Bellomo
OBJECTIVE: Of the 230 million patients undergoing major surgical procedures every year, more than 1 million will die within 30 days. Thus, any nonsurgical interventions that help reduce perioperative mortality might save thousands of lives. The authors have updated a previous consensus process to identify all the nonsurgical interventions, supported by randomized evidence, that may help reduce perioperative mortality. DESIGN AND SETTING: A web-based international consensus conference...
August 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27684548/levosimendan-administration-in-limb-ischemia-multicomponent-signaling-serving-kidney-protection
#19
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
https://www.readbyqxmd.com/read/27673371/reversible-covalent-binding-to-cardiac-troponin-c-by-the-ca-2-sensitizer-levosimendan
#20
Ian M Robertson, Sandra E Pineda-Sanabria, Ziqian Yan, Thomas Kampourakis, Yin-Biao Sun, Brian D Sykes, Malcolm Irving
The binding of Ca(2+) to cardiac troponin C (cTnC) triggers contraction in heart muscle. In the diseased heart, the myocardium is often desensitized to Ca(2+), which leads to impaired contractility. Therefore, compounds that sensitize cardiac muscle to Ca(2+) (Ca(2+)-sensitizers) have therapeutic promise. The only Ca(2+)-sensitizer used regularly in clinical settings is levosimendan. While the primary target of levosimendan is thought to be cTnC, the molecular details of this interaction are not well understood...
November 1, 2016: Biochemistry
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