Levosimendan Improves Function Of Stunned Myocardium After Angioplasty

NEW YORK (Reuters Health) - The calcium sensitizer levosimendan improves the function of stunned myocardium after percutaneous transluminal coronary angioplasty for acute coronary syndrome, according to a report in the June 16th Journal of the American College of Cardiology.

Levosimendan improves systolic function without impairing diastolic function, the authors explain, suggesting that calcium sensitization might improve the function of stunned myocardium, where systolic dysfunction is often combined with marked diastolic dysfunction.

Dr. Steffen Sonntag from Free University Berlin and colleagues studied the effects of levosimendan on left ventricular systolic and diastolic function in 24 patients with an acute coronary syndrome who underwent angioplasty.

Levosimendan resulted in slight decreases in mean aortic pressure and pulmonary artery pressure and considerable decreases in pulmonary capillary wedge pressure, the authors report, compared with slight increases in all three in placebo patients.

Systolic pressure-volume relationships indicative of systolic function improved in 8 of 16 levosimendan patients, but only 1 of 8 patients receiving placebo, the report indicates.

Diastolic pressure-volume relationships were variable, the researchers note, improving in 5 levosimendan patients and 5 placebo patients and worsening in 7 levosimendan patients and 1 placebo patient. All such changes, however, were minor and statistically insignificant.

"Levosimendan can restore the function of stunned myocardium in patients with acute myocardial infarction and severe acute left ventricular pumping failure," Dr. Sonntag told Reuters Health. "Inodilator therapy is a new concept in the treatment of acute heart failure."

"Levosimendan is most useful in the setting of severe acute heart failure due to acute coronary syndrome," Dr. Sonntag added. "Therefore, further studies will evaluate the effects of levosimendan on survival of patients with acute heart failure especially in need of intravenous inotropic support. We hope that levosimendan improves survival in contrast to other positive inotropic drugs like catecholamines."

Source: J Am Coll Cardiol 2004;43:2177-2182. [ Google search on this article ]

MeSH Headings: Calcium-Binding Proteins : Drugs, Investigational