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Levosimendan

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https://www.readbyqxmd.com/read/29653089/modification-of-levosimendan-induced-suppression-of-atrial-natriuretic-peptide-secretion-in-hypertrophied-rat-atria
#1
Lamei Yu, Kuichang Yuan, Byung Mun Park, Suhn Hee Kim
This study aimed to determine the effects of levosimendan, a calcium sensitizer, on atrial contractility and atrial natriuretic peptide (ANP) secretion and its modification in hypertrophied atria. Isolated perfused beating rat atria were used from control and isoproterenol-treated rats. Levosimendan and its metabolite OR-1896 caused a positive inotropic effect and suppressed ANP secretion in rat atria. Similar to levosimendan, the selective phosphodiesterase 3 (PDE3) or PDE4 inhibitor also suppressed ANP secretion...
April 10, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#2
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628139/drug-repurposing-in-kidney-disease
#3
REVIEW
Usha Panchapakesan, Carol Pollock
Drug repurposing, is the re-tasking of known medications for new clinical indications. Advantages, compared to de novo drug development, include reduced cost and time to market plus the added benefit of a known pharmacokinetic and safety profiles. Suitable drug candidates are identified through serendipitous observations, data mining, or increased understanding of disease mechanisms. This review highlights drugs suited for repurposing in kidney disease. The main cause of mortality in patients with chronic kidney disease is cardiovascular disease...
April 6, 2018: Kidney International
https://www.readbyqxmd.com/read/29602841/effect-of-levosimendan-on-mortality-in-severe-sepsis-and-septic-shock-a-meta-analysis-of-randomised-trials
#4
Wei Chang, Jian-Feng Xie, Jing-Yuan Xu, Yi Yang
OBJECTIVE: We aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock. METHODS: A collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported...
March 30, 2018: BMJ Open
https://www.readbyqxmd.com/read/29595109/levosimendan-reduces-prostaglandin-f2a-dependent-vasoconstriction-in-physiological-vessels-and-after-experimentally-induced-subarachnoid-hemorrhage
#5
Stefan Wanderer, Jan Mrosek, Florian Gessler, Volker Seifert, Juerge Konczalla
Background Delayed cerebral vasospasm (dCVS) following aneurysmal subarachnoid hemorrhage (aSAH) is (next to possible aneurysm rebleeding, cortical spreading depression and early brain injury) one of the main factors contributing to poor overall patient outcome. Since decades intensive research has been ongoing with the goal of improving our understanding of the pathophysiological principles underlying dCVS. Endothelin-1 (ET-1) and prostaglandin F2 alpha (PGF2a) seem to play a major role during dCVS. The synthesis of ET-1 is enhanced after subarachnoid hemorrhage (SAH) to mediate a long-lasting vasoconstriction, and PGF2a contributes to cerebral inflammation and vasoconstriction...
March 28, 2018: Current Neurovascular Research
https://www.readbyqxmd.com/read/29581038/levosimendan-following-cardiac-surgery
#6
Sean M Conte, Daniel S Florisson, Joshua A De Bono, Reece A Davies, Andrew E Newcomb
A best evidence topic was written to address if perioperative levosimendan improves mortality following cardiac surgery. Fourteen papers represented the best available evidence. An older meta-analysis summarising 11 of these trials concluded that there were fewer deaths in the levosimendan group compared to the control group (OR 0.41, p <0.001) however, this was driven by the results of three included trials by the same author. Three larger and more recent randomised controlled trials failed to demonstrate significant differences in mortality...
March 6, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29580796/effect-of-levosimendan-on-renal-outcome-in-cardiac-surgery-patients-with-chronic-kidney-disease-and-perioperative-cardiovascular-dysfunction-a-substudy-of-a-multicenter-randomized-trial
#7
Alberto Zangrillo, Gabriele Alvaro, Alessandro Belletti, Antonio Pisano, Luca Brazzi, Maria G Calabrò, Fabio Guarracino, Tiziana Bove, Evgeny V Grigoryev, Fabrizio Monaco, Vladimir A Boboshko, Valery V Likhvantsev, Anna M Scandroglio, Gianluca Paternoster, Rosalba Lembo, Samuele Frassoni, Marco Comis, Vadim V Pasyuga, Paolo Navalesi, Vladimir V Lomivorotov
OBJECTIVE: Acute kidney injury (AKI) occurs frequently after cardiac surgery. Levosimendan might reduce the incidence of AKI in patients undergoing cardiac surgery. The authors investigated whether levosimendan administration could reduce AKI incidence in a high-risk cardiac surgical population. DESIGN: Post hoc analysis of a multicenter randomized trial. SETTING: Cardiac surgery operating rooms and intensive care units of 14 centers in 3 countries...
February 26, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29573810/meta-analysis-of-trials-on-prophylactic-use-of-levosimendan-in-patients-undergoing-cardiac-surgery
#8
Ayman Elbadawi, Islam Y Elgendy, Marwan Saad, Michael Megaly, Amgad Mentias, Ahmed S Abuzaid, Hend I Shahin, Vinay Goswamy, Hesham Abowali, Barry London
BACKGROUND: The role of prophylactic levosimendan in patients undergoing cardiac surgery is controversial. METHODS: We performed a computerized search of Medline, Embase, and Cochrane databases through September 2017 for randomized trials evaluating the prophylactic use of levosimendan in patients undergoing cardiac surgery (ie, patients without low cardiac output syndrome). The main study outcome was mortality at 30 days. RESULTS: The final analysis included 16 randomized trials with total of 2,273 patients...
March 21, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29564979/levosimendan-for-perioperative-cardioprotection-myth-or-reality
#9
Elpidio Santillo, Monica Migale, Carlo Massini, Raffaele Antonelli Incalzi
BACKGROUND: Levosimendan is a calcium sensitizer drug causing increased contractility in the myocardium and vasodilation in the vascular system. It is mainly used for the therapy of acute decompensated heart failure. Several studies on animals and humans provided evidence of the cardioprotective properties of levosimendan including preconditioning and anti-apoptotic. In view of these favorable effects, levosimendan has been tested in patients undergoing cardiac surgery for the prevention or treatment of low cardiac output syndrome...
March 21, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29558109/the-reversible-covalent-reaction-of-levosimendan-with-cardiac-troponin-c-in-vitro-and-in-situ
#10
Brittney Ann Klein, Béla Reiz, Ian Michael Robertson, Malcolm Irving, Liang Li, Yin-Biao Sun, Brian D Sykes
The development of calcium sensitizers for the treatment of systolic heart failure presents difficulties including judging the optimal efficacy and the specificity to target cardiac muscle. The thin filament is an attractive target since cardiac troponin-C (cTnC) is the site of calcium binding and the trigger for subsequent contraction. One widely studied calcium sensitizer is levosimendan. We have recently shown that when a covalent cTnC-levosimendan analog is exchanged into cardiac muscle cells, they become constitutively active, demonstrating the potency of a covalent complex...
March 20, 2018: Biochemistry
https://www.readbyqxmd.com/read/29548887/surfactant-proteins-changes-after-acute-hemodynamic-improvement-in-patients-with-advanced-chronic-heart-failure-treated-with-levosimendan
#11
Jeness Campodonico, Massimo Mapelli, Emanuele Spadafora, Stefania Ghilardi, Piergiuseppe Agostoni, Cristina Banfi, Susanna Sciomer
Alveolar-capillary membrane evaluated by carbon monoxide diffusion (DLCO) plays an important role in heart failure (HF). Surfactant Proteins (SPs) have also been suggested as a worthwhile marker. In HF, Levosimendan improves pulmonary hemodynamics and reduces lung fluids but associated SPs and DLCO changes are unknown. Sixty-five advanced HF patients underwent spirometry, cardiopulmonary exercise test (CPET) and SPs determination before and after Levosimendan. Levosimendan caused natriuretic peptide-B (BNP) reduction, peakVO2 increase and VE/VCO2 slope reduction...
March 13, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29482882/vasodilators-in-acute-heart-failure-evidence-based-on-new-studies
#12
REVIEW
André M Travessa, L Menezes Falcão
Acute heart failure (AHF) contributes largely to the worldwide burden of heart failure (HF) and is associated with high mortality, poor prognosis and high rehospitalization rate. The pharmacologic therapy of AHF includes diuretics and vasodilators, which are a keystone when fluid overload and congestion are present. However, vasodilators are mainly focused on controlling symptoms, and drugs that also improve long-term mortality and morbidity seem to be in high demand. In this review, we summarize the existing evidence on mortality benefits of IV vasodilators in AHF...
February 23, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29479665/scandinavian-ssai-clinical-practice-guideline-on-choice-of-inotropic-agent-for-patients-with-acute-circulatory-failure
#13
REVIEW
M H Møller, A Granholm, E Junttila, M Haney, A Oscarsson-Tibblin, A Haavind, J H Laake, E Wilkman, K Ö Sverrisson, A Perner
BACKGROUND: Adult critically ill patients often suffer from acute circulatory failure and those with low cardiac output may be treated with inotropic agents. The aim of this Scandinavian Society of Anaesthesiology and Intensive Care Medicine guideline was to present patient-important treatment recommendations on this topic. METHODS: This guideline was developed according to GRADE. We assessed the following subpopulations of patients with shock: (1) shock in general, (2) septic shock, (3) cardiogenic shock, (4) hypovolemic shock, (5) shock after cardiac surgery, and (6) other types of shock, including vasodilatory shock...
February 25, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29469177/haemodynamic-effects-of-levosimendan-in-advanced-but-stable-chronic-heart-failure
#14
Emil Najjar, Marcus Stålhberg, Camilla Hage, Erica Ottenblad, Aristomenis Manouras, Ida Haugen Löfman, Lars H Lund
AIMS: Levosimendan improves haemodynamics in acute decompensated heart failure (HF). However, it is increasingly used for repetitive or intermittent infusions in advanced but stable chronic HF, without clear indication, selection criteria, or effect. We tested the hypotheses that (1) levosimendan improves haemodynamics in stable chronic HF and (2) that the response is dependent on baseline clinical and haemodynamic factors. METHODS AND RESULTS: Twenty-three patients [median age 56 (49-64) years, four (17%) women] with stable New York Heart Association (NYHA) III and IV HF received a single 24 h levosimendan infusion...
February 22, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29424484/acute-heart-failure-following-myocardial-infarction-complement-activation-correlates-with-the-severity-of-heart-failure-in-patients-developing-cardiogenic-shock
#15
Hilde L Orrem, Per H Nilsson, Søren E Pischke, Guro Grindheim, Peter Garred, Ingebjørg Seljeflot, Trygve Husebye, Pål Aukrust, Arne Yndestad, Geir Ø Andersen, Andreas Barratt-Due, Tom E Mollnes
AIMS: Heart failure (HF) is an impending complication to myocardial infarction. We hypothesized that the degree of complement activation reflects severity of HF following acute myocardial infarction. METHODS AND RESULTS: The LEAF trial (LEvosimendan in Acute heart Failure following myocardial infarction) evaluating 61 patients developing HF within 48 h after percutaneous coronary intervention-treated ST-elevation myocardial infarction herein underwent a post hoc analysis...
February 9, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29415177/effect-of-levosimendan-on-clinical-outcomes-in-adult-patients-undergoing-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#16
Xiaoyang Zhou, Caibao Hu, Zhaojun Xu, Peng Liu, Yuchu Zhang, Lingling Sun, Yang Wang, Xiaofei Gao
It is currently unknown whether levosimendan can improve clinical outcomes in patients undergoing cardiac surgery. This meta-analysis aimed to assess the effect of levosimendan on mortality and the duration of intensive care unit (ICU) and hospital stay in adult patients undergoing cardiac surgery. A comprehensive search for eligible articles was conducted in PubMed, OVID and Cochrane databases of clinical trials and the Web of Science from database inception to August 2017. Stata/SE 11.0 was used to calculate the pooled odds ratio for postoperative mortality and the pooled standardized mean difference (SMD) for the duration of ICU stay and hospital stay...
February 3, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29405611/efficacy-and-safety-of-intermittent-intravenous-outpatient-administration-of-levosimendan-in-patients-with-advanced-heart-failure-the-lion-heart-multicentre-randomised-trial
#17
Josep Comín-Colet, Nicolás Manito, Javier Segovia-Cubero, Juan Delgado, José Manuel García Pinilla, Luis Almenar, María G Crespo-Leiro, Alessandro Sionis, Teresa Blasco, Domingo Pascual-Figal, Francisco Gonzalez-Vilchez, José Luis Lambert-Rodríguez, María Grau, Jordi Bruguera
AIMS: The LION-HEART study was a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial evaluating the efficacy and safety of intravenous administration of intermittent doses of levosimendan in outpatients with advanced chronic heart failure. METHODS AND RESULTS: Sixty-nine patients from 12 centres were randomly assigned at a 2:1 ratio to levosimendan or placebo groups, receiving treatment by a 6-hour intravenous infusion (0.2 μg/kg/min without bolus) every 2 weeks for 12 weeks...
February 6, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29400260/noteworthy-literature-published-in-2017-for-cardiothoracic-anesthesiologists
#18
Dirk J Varelmann, Jochen Daniel Muehlschlegel
The year 2017 was a year dominated by large-scale clinical studies reporting the outcome of various interventions in cardiac surgery and heart failure (HF) patients, relevant to all cardiothoracic anesthesiologists. Among them were studies investigating the addition of levosimendan, an alternative inotropic agent, to standard management of patients with HF undergoing cardiac surgery. Also, corticosteroids have been used for various purposes in cardiac patients. Here, a new study reports the effect of high-dose methylprednisolone on recovery and delirium...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29395891/hemodynamic-support-of-a-15-year-old-waiting-for-a-heart-transplant-is-there-a-role-for-levosimendan-in-pediatric-heart-failure
#19
I Goyer, D Brossier, B Toledano
Decompensated heart failure in children requires rapid and aggressive support. In refractory cases, invasive supportive care is essential to ensure cardiac output. This results in lengthy pediatric intensive care unit (PICU) stays, secondary morbidity, and high cost. Levosimendan may help palliate the pitfalls encountered with the usual treatment. It has been shown to improve hemodynamics and decrease morbidity and mortality from heart failure in adult trials and pediatric cohorts. We report the case of a 15-year-old boy with dilated cardiomyopathy and refractory ventricular dysfunction who was weaned from continuous inotropes and discharged from the PICU with levosimendan while waiting for heart transplantation...
February 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29376560/inotropic-agents-and-vasodilator-strategies-for-the-treatment-of-cardiogenic-shock-or-low-cardiac-output-syndrome
#20
REVIEW
Julia Schumann, Eva C Henrich, Hellen Strobl, Roland Prondzinsky, Sophie Weiche, Holger Thiele, Karl Werdan, Stefan Frantz, Susanne Unverzagt
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs...
January 29, 2018: Cochrane Database of Systematic Reviews
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