A new inotropic agent in the treatment of decompensated heart failure: Levosimendan [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2007; 35(1): 48-56

A new inotropic agent in the treatment of decompensated heart failure: Levosimendan

Dursun Aras, Serkan Topaloğlu, Şule Korkmaz
Turkey Training and Research Hospital, Department of Cardiology, Ankara, Turkey

Positive inotropic agents such as beta-adrenergic agonists or phosphodiesterase III inhibitors provide significant hemodynamic benefits in the short-term treatment of decompensated heart failure, but they have unfavorable effects on survival in the long-term. Calcium sensitizer agents represent a new and different class of inotropic agents that increase cardiac contractility without increasing cAMP and intracellular calcium concentrations. Among them, levosimendan is the most potent drug with inotropic and vasodilatory effects. Preliminary studies showed that levosimendan was associated with symptomatic improvement, decreased mortality, and better tolerance in the treatment of both acute decompansation of chronic heart failure and acute heart failure following myocardial infarction. However, the results of larger studies recently published show that levosimendan is superior to placebo only in symptomatic improvement and is not favored over placebo or dobutamine with regard to its effect on mortality. Moreover, an increased incidence of arrhythmias have been reported. These data suggest that further studies are needed regarding the use of levosimendan.

Keywords: Calcium/metabolism, cardiotonic agents, heart failure, congestive

How to cite this article
Dursun Aras, Serkan Topaloğlu, Şule Korkmaz. A new inotropic agent in the treatment of decompensated heart failure: Levosimendan. Turk Kardiyol Dern Ars. 2007; 35(1): 48-56

Corresponding Author: Dursun Aras, Türkiye
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