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2003, Number 1

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Gac Med Mex 2003; 139 (1)

Levosimendan: A New Option in Pharmacologic Management of Cardiac Insufficiency.

Del-Razo OE, Carballal-Sanjurjo JC, Campos LMG, Palma-Aguirre JA
Full text How to cite this article

Language: Spanish
References: 8
Page: 87-89
PDF size: 60.02 Kb.


Key words:

Levosimendan, heart failure, lusitropism, inotropism, cronotropism.

ABSTRACT

The congestive heart failure is a pathological process characterized by the incapacity of the heart to maintain an adequate cardiac perfusion for the tissue metabolism, and that can be secondary to diverse causes, that give as result, alterations in the lusitropism, inotropism or in the cronotropism. Over 4,6 persons per hundred in the United States alone carry this diagnosis, and it is the cause of death in several hundred thousand patients each year, with a 35% mortality over 5 years. In the last years, have existed important advances in the pharmacological treatment of this disease in it´s terminal stages. The increase in the knowledge on the physiopathology of the heart failure, has taken place for the use of new schemes of treatment, where it excels the use of vasoactive amines, Angiotensin Converting Enzyme Inhibitors, angiotensin II receptor AT1 antagonists, etc; nevertheless we whereupon that most of these drugs that at the present display a favorable answer to the disease, has the disadvantage of increasing the consumption of oxygen by the own myocardium tissue. Levosimendan has a better profile of security than its predecessors (amrinone and milrinone), improves the haemodynamics parameters of special significant form in the cardiac output, the systolic pressure of the pulmonary artery and the telediastolic pressure of the left ventricle, without significantly increasing the consumption of oxygen by the myocardium. Levosimendan is a new and relevant calcium sensitizer developed for the short-term intravenous treatment of congestive heart failure.


REFERENCES

  1. American Heart Association. 2000 Heart and Stroke Statistical Update, A.H.A. Dallas, 1999.

  2. Jaagosid P, Dawson NV, Thomas C, et al. Outcomes of acute exacerbation of severe congestive heart failure: quality of life, resources use, and survival. Arch Intern Med 1998; (158): 1081-1089.

  3. Ooi H, Colucci WS. Pharmacological treatment of Heart failure. In: Goodman & Gilman‘s The Pharmacological Basis of Therapeutics. Hardman JG, Limbrid LE, Goodman GA. (eds) McGraw-Hill. 10th edition, 2001, pp 901-932..

  4. Hasenfuss G, Pieske B, Castell M, et al. Influence of the novel inotropic agent levosimendan on isometric tension and calcium cycling in failing human myocardium. Circulation 1998; 98(20): 2141-2147.

  5. Bowman P, Haikala H, Paul R. Levosimendan, a calcium sensitizer in cardiac muscle, induces relaxation in coronary smooth muscle through calcium desensitization. J Pharmacol Exp Ther 1998; 288(1): 316-325.

  6. Slawski MT, Wilson CS, Gottliev SS, et al. Acute hemodynamic and clinical effects of Levosimendan in patients with severe heart failure. Circulation 2000; 102:2222-2227.

  7. Nieminen,M.S., Akkila,J., Hasenfuss,G., et al. Hemodynamic and Neurohumoral Effects of Continuous Infusión of levosimendan in Patients with Congestive Heart Failure. J Amer Coll Cardiol 2000; 36: 1903-1912.

  8. Follath F, Cleland JG, Just H, et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomized double-blind trial. Lancet 2002; 360(9328): 196-202.




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Gac Med Mex. 2003;139