ID Design 2012/DOOEL Skopje, Republic of
Macedonia
Open Access Macedonian Journal of Medical Sciences.
http://dx.doi.org/10.3889/oamjms.2016.071
eISSN: 1857-9655
Review Article
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The Role of Levosimendan in
Patients with Decreased Left Ventricular Function Undergoing Cardiac Surgery
Marija Bozhinovska1*, Gordana Taleska1,
Andrej Fabian2,3, Maja Šoštarič1
1Clinical Department of Anesthesiology and Perioperative
Intensive Therapy, Division of Cardiac Anesthesiology and Intensive Therapy,
University Clinical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia;
2Institute of Physiology, Medical Faculty, University of
Ljubljana, Slovenia; 3Department of Vascular Neurology and
Neurological Intensive Therapy, University Clinical Centre Ljubljana,
Slovenia
The postoperative low cardiac output is one of the most important
complications following cardiac surgery and is associated with increased
morbidity and mortality. The condition requires inotropic support to achieve
adequate hemodynamic status and tissue perfusion. While catecholamines are
utilised as a standard therapy in cardiac surgery, their use is limited due
to increased oxygen consumption. Levosimendan is calcium sensitising
inodilatator expressing positive inotropic effect by binding with cardiac
troponin C without increasing oxygen demand. Furthermore, the drug opens
potassium ATP (KATP) channels in cardiac mitochondria and in the vascular
muscle cells, showing cardioprotective and vasodilator properties,
respectively. In the past decade, levosimendan demonstrated promising
results in treating patients with reduced left ventricular function when
administered in peri- or post- operative settings. In addition,
pre-operative use of levosimendan in patients with severely reduced left
ventricular ejection fraction may reduce the requirements for postoperative
inotropic support, mechanical support, duration of intensive care unit stay
as well as hospital stay and a decrease in post-operative mortality.
However, larger studies are needed to clarify clinical advantages of
levosimendan versus conventional inotropes.
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Citation: Bozhinovska M, Taleska G, Fabian A,
Šoštarič M. The Role of Levosimendan in Patients with Decreased Left
Ventricular Function Undergoing Cardiac Surgery. Open Access Maced J Med
Sci. http://dx.doi.org/10.3889/oamjms.2016.071
Keywords: Cardiac surgery; Levosimendan; Ventricular function; Heart
failure; Myocardial dysfunction.
*Correspondence: Marija Bozhinovska, MD. Zaloska 7, SI-1000
Ljubljana, Slovenia. Tel: + 386 70 321 247. E-mail: marija.bozinovska@kclj.si
Received: 18-Jun-2016; Revised: 21-Jun-2016; Accepted: 25-Jun-2016; Online
first: 28-Jun-2016
Copyright: © 2016 Marija Bozhinovska, Gordana Taleska, Andrej Fabian,
Maja Šoštarič.
This is an open access article distributed under the terms of the Creative
Commons Attribution License, which permits unrestricted use, distribution,
and reproduction in any medium, provided the original author and source are
credited.
Competing Interests: The authors have declared that no competing
interests exist.
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Bozhinovska M
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Taleska G
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Fabian A
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Šoštarič M
PubMed
- Bozhinovska M
- Taleska G
- Fabian A
- Šoštarič M
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