Dose-range study of a new calcium sensitizer, levosimendan, in patients with left ventricular dysfunction

摘要: Levosimendan, a new drug that sensitizes troponin-C to calcium and selectively inhibits phosphodiesterase III, was administered 24 patients with ischemic heart disease ejection fraction below 40%. In placebo-controlled, crossover, double-blind study, each patient received two intravenous doses of levosimendan on 2 consecutive study days. The were 0.25 mg (n = 6), 0.5 11), 1 12), 4 5). After mg, cardiac output increased by 0.49-0.67 L/min (p < 0.05) due an increase in stroke volume 6-11 ml. 0.61-0.88 rate 6-12 beats/min. baseline filling pressures, i.e., right atrial pressure (RAP) pulmonary capillary wedge (PCWP), within the normal range. RAP decreased significantly after PCWP 0.5, 1, 2, mg. most profound decreases observed 10 min infusion from 5.0 3.2 mm Hg 9.8 6.0 PCWP. Total peripheral resistance only 13 21%, respectively. However, there no statistically significant changes vascular resistance. It is concluded has hemodynamically favorable action but pressures probably prevented caused reflex