Levosimendan, a New Inodilator agent review study

Levosimendan, a myofilament Ca2 sensitizer with inotropic effects, increases myocardial performance without substantial changes in oxygen consumption and with neutral effects on heart rhythm. In addition, levosimendan has vasodilatory effects that are acheived by stimulation of adenosine triphosphate–dependent potassium channels. This action may be of specific interest in the setting of myocardial ischemia.To date, levosimendan is approved in 31 countries worldwide, and more patients with heart failure have particepated in randomized controlled trials with levosimendan than with any other intravenous inotropic agent. This review compares the different actions of standard positive inotropic drugs and Ca2 sensitizers. It also summerizes the current experimental and clinical knowledge of the use of levosimendan and gives practical recommendations with a special focus on the perioperative setting.