Levosimendan is an inodilator:
- calcium sensitising inotrope
- ATP sensitive potassium channel opener (vasodilator)
It increases cardiac output without increasing myocardial oxygen demand
- reduces preload and afterload
- increases heart rate and stroke volume
- reduces systemic vascular resistance
180+ papers on Pubmed – difficult to unpick definitive outcomes (heterogenous patient populations and varying endpoints.
Journal article discussed:
“Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery”
Main finding – as a prophylactic agent, no clinical benefit in poor LVEF cardiac surgery.
Compared to placebo, no change in composite endpoint of death, renal replacement therapy, infarct OR need for a mechanical cardiac assist device.
The findings of this study are unlikely to change clinical practice.
Also of note: Levosimendan is currently very expensive in Australia!
Just in case you were unsure…