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Levosimendan

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https://www.readbyqxmd.com/read/29926912/inotropic-and-lusitropic-effects-of-levosimendan-and-milrinone-assessed-by-strain-echocardiography-a-randomised-trial
#1
M Fredholm, K Jörgensen, E Houltz, S-E Ricksten
BACKGROUND: We compared the direct inotropic and lusitropic effects of two inodilators, milrinone and levosimendan in patients after aortic valve replacement for aortic stenosis. METHODS: In this randomised, blinded study, 31 patients with normal LV function, were randomised to either levosimendan (0.1 and 0.2 μg/kg/min, n = 15) or milrinone (0.4 and 0.8 μg/kg/min, n = 16) after aortic valve replacement. The effects on LV performance, LV strain, systolic (SR-S) and early diastolic (SR-E) strain rate were assessed by a pulmonary artery catheter and transoesophageal two-dimensional speckle tracking echocardiography of the LV inferior wall...
June 21, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29925127/-the-effects-of-levosimendan-on-the-cardiac-function-and-prognosis-in-elderly-patients-with-septic-shock-and-myocardial-contractility-impairment
#2
C X Xu, L Li, S J Gong, Y H Yu, J Yan
Objective: To investigate the effect of levosimendan on cardiac function and prognosis in elderly patients with septic myocardial contractility impairment. Methods: A prospective, randomized, controlled study was conducted. The elderly patients with septic myocardial contractility impairment who were admitted to Intensive Care Unit in Zhejiang Hospital were consecutively enrolled from January 2017 to September 2017. The key inclusive criterion was left ventricular ejection fraction (LVEF) ≤50% after fluid resuscitation...
June 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29922941/cardioprotective-and-functional-effects-of-levosimendan-and-milrinone-in-mice-with-cecal-ligation-and-puncture-induced-sepsis
#3
Shigeyuki Yamashita, Tokiko Suzuki, Keisuke Iguchi, Takuya Sakamoto, Kengo Tomita, Hiroki Yokoo, Mari Sakai, Hiroki Misawa, Kohshi Hattori, Toshi Nagata, Yasuhide Watanabe, Naoyuki Matsuda, Naoki Yoshimura, Yuichi Hattori
Levosimendan and milrinone may be used in place of dobutamine to increase cardiac output in septic patients with a low cardiac output due to impaired cardiac function. The effects of the two inotropic agents on cardiac inflammation and left ventricular (LV) performance were examined in mice with cecal ligation and puncture (CLP)-induced sepsis. CLP mice displayed significant cardiac inflammation, as indicated by highly increased pro-inflammatory cytokines and neutrophil infiltration in myocardial tissues. When continuously given, levosimendan prevented but milrinone exaggerated cardiac inflammation, but they significantly reduced the elevations in plasma cardiac troponin-I and heart-type fatty acid-binding protein, clinical markers of cardiac injury...
June 20, 2018: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/29908289/decreased-contractility-and-altered-responses-to-inotropic-agents-in-myocytes-from-tachypacing-induced-heart-failure-canines
#4
BaoXi Gao, Yusheng Qu, Weston Sutherland, Ray W Chui, Kim Hoagland, Hugo M Vargas
Contractility measurements using primary isolated cardiac myocytes (CM) have commonly been used in understanding the physiology and pharmacology of cellular mechanics. In the majority of studies, CM from healthy animals were used, and fewer studies were performed with CM from diseased hearts. To better understand the translational value of contractility on the cellular level of a diseased animal model, myocytes were isolated from left ventricles of a tachypacing-induced heart failure (HF) canine model, and their contractility was measured by recording sarcomere shortening using an image-based IonOptix video system...
June 13, 2018: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29861626/assessment-of-the-effects-of-levosimendan-and-thymoquinone-on-lung-injury-after-myocardial-ischemia-reperfusion-in-rats
#5
Şaban Cem Sezen, Aysegul Kucuk, Abdullah Özer, Yiğit Kılıç, Barış Mardin, Metin Alkan, Fatmanur Duruk Erkent, Mustafa Arslan, Yusuf Ünal, Gürsel Levent Oktar, Murat Tosun
Aim: The aim of this study was to investigate the effects of levosimendan and thymoquinone (TQ) on lung injury after myocardial ischemia/reperfusion (I/R). Materials and methods: Twenty-four Wistar albino rats were included in the study. The animals were randomly assigned to 1 of 4 experimental groups. In Group C (control group), left anterior descending artery was not occluded or reperfused. Myocardial I/R was induced by ligation of the left anterior descending artery for 30 min, followed by 2 h of reperfusion in the I/R, I/R-levosimendan (24 µg/kg) (IRL) group, and I/R-thymoquinone (0...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29847385/reversing-cholinergic-bronchoconstriction-by-common-inotropic-agents-a-randomized-experimental-trial-on-isolated-perfused-rat-lungs
#6
Gergely H Fodor, Sam Bayat, Barna Babik, Walid Habre, Ferenc Peták
BACKGROUND: The ability of inotropic agents to alter airway reactivity and lung tissue mechanics has not been compared in a well-controlled experimental model. Therefore, we compared the potential to alter lung tissue viscoelasticity and bronchodilator effects of commonly used inotropic agents in an isolated perfused rat lung model. METHODS: After achieving steady state lung perfusion, sustained bronchoconstriction was induced by acetylcholine (ACh). Isolated rat lungs were then randomly allocated to 6 groups treated with either saline vehicle (n = 8) or incremental concentrations of inotropes (adrenaline, n = 8; dopamine, n = 7; dobutamine, n = 7; milrinone, n = 8; or levosimendan, n = 6) added to the whole-blood perfusate...
May 25, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29846206/sepsis-induced-myocardial-dysfunction
#7
Keith R Walley
PURPOSE OF REVIEW: Sepsis leads to a complex intramyocardial inflammatory response that results in sepsis-induced myocardial dysfunction. Here, recent findings are reviewed in a physiologic context. RECENT FINDINGS: Decreased systolic contractility during sepsis limits ventricular ejection and stroke volume. Initially, this effect is compensated for by increased diastolic filling during volume resuscitation. Reduced afterload due to arterial vasodilation also compensates so that cardiac output can be maintained or increased...
May 24, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29806474/-perioperative-use-of-levosimendan-in-cardiac-surgery-hungarian-recommendation
#8
László Szudi, László Székely, Erzsébet Sápi, Zsolt Prodán, Jenő Szolnoky, Ákos Csomós, Noémi Nyolczas, Erzsébet Paulovich, Endre Németh, István Hartyánszky, Endre Zima, Balázs Sax, Andrea Bertalan, László Hejjel, Gábor Bogáts, Barna Babik, Károly Gombocz, Tamás Szerafin, György Koszta, Andrea Molnár
Low output syndrome significantly increases morbidity and mortality of cardiac surgery and lengthens the durations of intensive care unit and hospital stays. Its treatment by catecholamines can lead to undesirable systemic and cardiac complications. Levosimendan is a calcium sensitiser and adenosine triphosphate (ATP)-sensitive potassium channel (IK,ATP ) opener agent. Due to these effects, it improves myocardium performance, does not influence adversely the balance between O2 supply and demand, and possesses cardioprotective and organ protective properties as well...
June 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29792513/cardiogenic-shock-complicating-peripartum-cardiomyopathy-importance-of-early-left-ventricular-unloading-and-bromocriptine-therapy
#9
Jan-Thorben Sieweke, Tobias Jonathan Pfeffer, Dominik Berliner, Tobias König, Maximiliane Hallbaum, L Christian Napp, Jörn Tongers, Christian Kühn, Jan D Schmitto, Denise Hilfiker-Kleiner, Andreas Schäfer, Johann Bauersachs
INTRODUCTION: Acute peripartum cardiomyopathy complicated by cardiogenic shock is a rare but life-threatening disease. A prolactin fragment is considered causal for the pathogenesis of peripartum cardiomyopathy. This analysis sought to investigate the role of early percutaneous mechanical circulatory support with micro-axial flow-pumps and/or veno-arterial extracorporeal membrane oxygenation in combination with the prolactin inhibitor bromocriptine in refractory cardiogenic shock complicating peripartum cardiomyopathy...
May 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29785788/effects-of-levosimendan-on-mortality-in-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis
#10
Peili Chen, Xiaoqiang Wu, Zhiwei Wang, Zhenya Li, Xiangyong Tian, Junpeng Wang, Tianzhong Yan
PURPOSE: We sought to determine the impact of levosimendan on mortality following cardiac surgery based on large-scale randomized controlled trials (RCTs). METHODS: We searched PubMed, Web of Science, Cochrane databases, and ClinicalTrials.gov for RCTs published up to December 2017, on levosimendan for patients undergoing cardiac surgery. RESULTS: A total of 25 RCTs enrolling 2960 patients met the inclusion criteria; data from 15 placebo-controlled randomized trials were included for meta-analysis...
May 21, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29777282/ambulatory-intravenous-inotropic-support-and-or-levosimendan-in-pediatric-and-congenital-heart-failure-safety-survival-improvement-or-transplantation
#11
Sotiria C Apostolopoulou, George A Vagenakis, Alexandros Tsoutsinos, Felicia Kakava, Spyridon Rammos
End-stage heart failure (HF) frequently needs continuous inotropic support in hospital and has high morbidity and mortality in absence of heart transplantation. This study reports outcome, efficacy, and safety of continuous ambulatory inotropes (AI) and/or periodic levosimendan (LS) infusions in pediatric HF patients. The study included 27 patients, median age 9.4 (0.1-26.1) years, with severe HF (6 myocarditis, 13 dilated cardiomyopathy, 2 restrictive cardiomyopathy, 6 repaired congenital heart disease). Dobutamine and milrinone AI were administered in 21 patients through a permanent central catheter for median duration 1...
May 18, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29773835/levosimendan-in-patients-with-left-ventricular-dysfunction-undergoing-cardiac-surgery-a-meta-analysis-and-trial-sequential-analysis-of-randomized-trials
#12
Zhenhua Xing, Liang Tang, Pengfei Chen, Jiabing Huang, Xiaofan Peng, Xinqun Hu
Patients with left ventricular dysfunction (LVD) undergoing cardiac surgery have a high mortality rate. Levosimendan, a calcium sensitizer, improves myocardial contractility without increasing myocardial oxygen demand. It is not clear whether levosimendan can reduce mortality in cardiac surgery patients with LVD. The PubMed, Embase, and Cochrane Central databases were searched to identify randomized trials comparing levosimendan with conventional treatment in cardiac surgery patients with LVD. We derived pooled risk ratios (RRs) with random effects models...
May 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#13
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29748076/comparison-of-levosimendan-and-milrinone-for-ecls-weaning-in-patients-after-cardiac-surgery-a-retrospective-before-and-after-study
#14
Annina Jacky, Alain Rudiger, Bernard Krüger, Markus J Wilhelm, Sebastian Paal, Burkhardt Seifert, Donat R Spahn, Dominique Bettex
OBJECTIVES: Pharmacodynamics suggests that levosimendan might be a valuable inotrope for weaning from extracorporeal life support (ECLS). As there is a paucity of evidence regarding the effectiveness and safety of such an approach, the aim was to report the authors' experiences in ECLS weaning before and after the implementation of levosimendan in clinical practice. DESIGN: Retrospective before-and-after study. SETTING: Cardiac intensive care unit of a university hospital...
April 6, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29733479/levosimendan-differentially-modulates-electrophysiological-activities-of-sinoatrial-nodes-pulmonary-veins-and-the-left-and-right-atria
#15
Yung-Kuo Lin, Yao-Chang Chen, Yi-Ann Chen, Jen-Hung Huang, Shih-Ann Chen, Yi-Jen Chen
INTRODUCTION: Calcium overload increases the risk of atrial fibrillation (AF). Levosimendan, a calcium sensitizer, increases myofilament contractility. Clinical reports suggested that levosimendan might increase AF occurrence, but the electrophysiological effects of levosimendan on AF substrates and triggers (pulmonary veins, PVs) are not clear. METHODS AND RESULTS: Conventional microelectrodes were used to record action potentials (APs) in isolated rabbit PVs, sinoatrial nodes (SANs), the left atrium (LA), and right atrium (RA) before and after application of different concentrations of levosimendan with or without milrinone (a phosphodiesterase [PDE] III inhibitor), and glibenclamide (an ATP-sensitive potassium channel [KATP ] inhibitor)...
May 7, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29722471/repetitive-levosimendan-for-a-lion-s-heart
#16
EDITORIAL
Johann Altenberger, Gerhard Pölzl
No abstract text is available yet for this article.
May 3, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29721682/-infarct-related-cardiogenic-shock-prognosis-and-treatment
#17
REVIEW
R Prondzinsky, H Lemm, A Geppert, M Buerke, M Russ, K Werdan
Patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) experience cardiogenic shock in about 6-10% of cases during the hospital treatment. In recent years, the incidence seems to be decreasing due to invasive diagnostics and therapy after myocardial infarction. Early diagnosis is important to initiate immediate revascularization using percutaneous coronary intervention (PCI) with stent implantation as part of cardiogenic shock treatment. Thus, a significant improvement in survival can be achieved...
May 2, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29718383/levosimendan-versus-placebo-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#18
María Ángeles Tena, Stefano Urso, Jesús María González, Luis Santana, Rafael Sadaba, Paula Juarez, Leonor González, Francisco Portela
The aim of this meta-analysis was to review all published randomized clinical trials comparing levosimendan versus placebo in patients undergoing cardiac surgery. PubMed, EMBASE and the Cochrane library database of clinical trials were searched for prospective randomized clinical trials investigating the perioperative use of levosimendan versus placebo in patients undergoing adult cardiac surgery from 1 May 2000 to 10 April 2017. Binary outcomes from individual studies were analysed to compute individual and pooled risk ratios (RRs) with pertinent 95% confidence intervals (CIs)...
April 30, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29685053/cardioprotective-and-anti-aggregatory-effects-of-levosimendan-on-isoproterenol-induced-myocardial-injury-in-high-fat-fed-rats-involves-modulation-of-pi3k-akt-mtor-signaling-pathway-and-inhibition-of-apoptosis-comparison-to-cilostazol
#19
Mona K Tawfik, Mohamed K El-Kherbetawy, Samy Makary
Hyperlipidemia and hypercoagulability states are linked with the increased risks of myocardial infarction (MI). Levosimendan has vasorelaxant and anti-aggregatory properties. The present study evaluated the anti-aggregatory and cardioprotective effects of levosimendan versus cilostazol in high-fat diet (HFD)-fed rats subjected to isoproterenol-induced MI. Rats were assigned to normal, HFD, HFD + isoproterenol, HFD + isoproterenol + cilostazol, and HFD + isoproterenol + levosimendan. The present study investigated the anti-aggregatory effect of both levosimendan and cilostazol and revealed that both drugs attenuated the severity of platelet aggregation...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29682727/pharmacological-interventions-for-protecting-renal-function-after-cardiac-surgery-a-bayesian-network-meta-analysis-of-comparative-effectiveness
#20
REVIEW
W H Kim, M Hur, S-K Park, D E Jung, P Kang, S Yoo, J-H Bahk
Many drugs have been investigated as potentially protective of renal function after cardiac surgery. However, their comparative effectiveness has not been established. We performed an arm-based hierarchical Bayesian network meta-analysis including 95 randomised controlled trials with 28,833 participants, which allowed us to compare some agents not previously compared directly. Renal outcomes, including: the incidence of postoperative renal dysfunction and haemodialysis; serum creatinine level at 24 hours postoperatively; all-cause mortality; and length of hospital and ICU stay, were compared...
April 16, 2018: Anaesthesia
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