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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

 

 

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

 

Abstract

 

 

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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Published by: Id Design 2012/DOOEL Skopje, Republic of Macedonia


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