Levosimenden is an inodilator:

  • calcium sensitising inotrope
  • ATP sensitive potassium channel opener (vasodilator)

It increases cardiac output without increasing myocardial oxygen demand

Clinically:

  • 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.

36FF01

Journal article discussed:

“Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery”

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1616218

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: Levosimenden is currently very expensive in Australia!

Links:

Life-in-the-FASTLANE

wikipedia

Just in case you were unsure…

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