Myocardial efficiency during levosimendan infusion in congestive heart failure View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2000-11

AUTHORS

Heikki Ukkonen, Markku Saraste, Juha Akkila, Juhani Knuuti, Meri Karanko, Hidehiro Iida, Pertti Lehikoinen, Kjell Någren, Lasse Lehtonen, Liisa‐Maria Voipio‐Pulkki

ABSTRACT

AIMS: Levosimendan, a novel calcium-dependent calcium sensitizer of the myocardial contractile proteins, also enhances diastolic relaxation and induces peripheral vasodilation by opening potassium channels. To assess the combined energetical effects of levosimendan infusion in vivo, we performed positron emission tomography in patients with decompensated chronic heart failure. METHODS AND RESULTS: Eight hospitalized patients with New York Heart Association functional class III or IV heart failure received levosimendan or placebo intravenously in a randomized double-blind cross-over study. During steady-state, dynamic positron emission tomography with [11C]acetate was used to assess myocardial oxygen consumption and [15O]H2O to measure myocardial blood flow. Cardiac performance and dimensions were assessed by pulmonary artery catheterization and echocardiography. Compared with healthy volunteers, myocardial oxygen consumption during placebo was elevated in the right ventricle but comparable in the left ventricle. During administration of levosimendan, cardiac output increased by 32% (P = .002) mainly because of higher stroke volume. Coronary, pulmonary, and systemic vascular resistance values were significantly reduced. Mean myocardial blood flow increased from 0.76 to 1.02 mL/min/g (P = .033). Levosimendan was neutral on myocardial oxygen consumption and left ventricular efficiency, but it improved right ventricular mechanical efficiency by 24% (P = .012). CONCLUSIONS: Levosimendan has an energetically favorable short-term profile in the treatment of congestive heart failure. It enhances cardiac output without oxygen wasting, particularly by improving efficiency in the right ventricle. More... »

PAGES

522-531

Identifiers

URI

http://scigraph.springernature.com/pub.10.1067/mcp.2000.110972

DOI

http://dx.doi.org/10.1067/mcp.2000.110972

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1053681110

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/11103755


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