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Titolo:
Levosimendan: a parenteral calcium-sensitising drug with additional vasodilatory properties
Autore:
Lehtonen, LA;
Indirizzi:
Univ Helsinki, Cent Hosp, Dept Clin Pharmacol, FIN-00029 Helsinki, FinlandUniv Helsinki Helsinki Finland FIN-00029 ol, FIN-00029 Helsinki, Finland
Titolo Testata:
EXPERT OPINION ON INVESTIGATIONAL DRUGS
fascicolo: 5, volume: 10, anno: 2001,
pagine: 955 - 970
SICI:
1354-3784(200105)10:5<955:LAPCDW>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONGESTIVE-HEART-FAILURE; CARDIAC TROPONIN-C; FAILING HUMAN MYOCARDIUM; GUINEA-PIG HEART; HEALTHY-VOLUNTEERS; SENSITIZING DRUG; HEMODYNAMIC INTERACTIONS; CA2+ SENSITIZER; K+ CHANNEL; PHARMACOKINETICS;
Keywords:
calcium-sensitivity; heart failure; inotropic drugs; levosimendan; myocardial ischaemia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
70
Recensione:
Indirizzi per estratti:
Indirizzo: Lehtonen, LA Univ Helsinki, Cent Hosp, Dept Clin Pharmacol, POB 340, FIN-00029 Helsinki, Finland Univ Helsinki POB 340 Helsinki Finland FIN-00029 ki, Finland
Citazione:
L.A. Lehtonen, "Levosimendan: a parenteral calcium-sensitising drug with additional vasodilatory properties", EXPERT OP I, 10(5), 2001, pp. 955-970

Abstract

Levosimendan (Simdax((R))) is a new inodilator developed specifically for the treatment of decompensated heart failure. its inotropic mechanism is based on calcium sensitisation of myofilaments and its vasodilator actions are related to the opening of ATP-dependent Ii-channels in the vasculature. Since the inotropic action of levosimendan does not require an increase in cytosolic free calcium, it is less arrhythmogenic than the conventional parenteral beta -agonist inotropes or PDE III inhibiting drugs. Due to the calcium-dependent binding of the drug to troponin C, levosimendan, unlike some other calcium-sensitising drugs, does nor prolong diastolic relaxation of the myocytes hut acts in synergy with the intramyocellular calcium levels. Furthermore, due to the anti-ischaemic effects of the K-channel opening in myocytes, levosimendan can be used during myocardial ischaemia. In clinical trials, levosimendan has dose-dependently increased cardiac output and decreased pulmonary capillary wedge pressure in patients with heart failure. Onthe other hand, it also increases heart rate and decreases blood pressure in these patients. In major clinical trials, where patients with decompensated heart failure have been treated with levosimendan, a reduction of overall mortality in comparison to placebo or dobutamine has been seen. This interesting finding should be verified in prospective outcome trials. In any case, the safety of levosimendan during myocardial ischaemia makes this drugvaluable in the short-term treatment of decompensated heart failure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 03:48:54