Skip to main content

Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Myocardial efficiency during levosimendan infusion

  • 1860 Accesses

Levosimendan (LS) is a novel agent indicated for the treatment of acute decompensated heart failure. It has a dual mechanism of action, increasing cardiac contractility without increasing myocardial oxygen demand as well as demonstrating vasodilator properties.

This double-blind, randomised, cross-over trial was conducted to assess the effects of LS on myocardial energetics in patients (n = 8) with New York Heart Association functional class III and IV heart failure. Patients initially received either placebo or intravenous LS (18 μg/kg bolus, followed by a continuous infusion of 0.3 μg/kg/min for 5 hours). The following day, patients who had received LS were given placebo and vice versa. Cardiac loading conditions and cardiac output (CO) were assessed using a Swan-Ganz catheter, thermodilution and echocardiography. Dynamic positron emission tomography (PET) with 11C-acetate and 15O-H2O was used to measure myocardial oxygen consumption (MVO2) and myocardial blood flow (MBF), respectively. Myocardial efficiency was calculated as (heart rate × stroke volume × arterial pressure) / ventricular oxygen consumption.

CO increased by 32% (P = 0.002) in patients receiving LS, mainly because of an increase in stroke volume. LS significantly reduced pulmonary capillary wedge pressure by 29% (P = 0.013), systemic vascular resistance by 26% (P < 0.001) and pulmonary vascular resistance by 28% (P = 0.025). Mean MBF was 0.76 ml/min/g with placebo and 1.02 ml/min/g with LS (P = 0.033). LS did not increase MVO2 significantly (8%). Left ventricular efficiency was comparable in LS-treated and placebo-treated patients, while right ventricular efficiency was improved by 24% (P = 0.012) with LS.

In conclusion, LS as well as having beneficial haemodynamic effects, also has an energetically favourable profile.

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Voipio-Pulkki, L., Ukkonen, H. Myocardial efficiency during levosimendan infusion. Crit Care 6, P137 (2002). https://doi.org/10.1186/cc1593

Download citation

Keywords

  • Stroke Volume
  • Myocardial Blood Flow
  • Pulmonary Vascular Resistance
  • Pulmonary Capillary Wedge Pressure
  • Levosimendan