Levosimedan improves hemodynamics functions without sympathetic activation in severe heart failure patients: direct evidence from sympathetic neural recording

Acute Cardiac Care
Fabien DespasAtul Pathak

Abstract

Levosimendan is a new inodilatory agent with calcium sensitizing activity. A major concern regarding the use of inotropic agent in heart failure is their effect on the sympathetic tone. This effect could explain increase in short term mortality with other inotropes. We aimed to assess the effect of levosimendan on sympathetic tone measured directly by microneurogra-phy. In a group of acute decompensated heart failure patients, we assessed cardiac performance by digital plethysmography measurement. Sympathetic tone was assessed through recording of muscle sympathetic nerve activity (MSNA) by micro-neurography. Recording were done blindly, for each patient after dobutamine perfusion was stopped (baseline) and 48 h after levosimendan infusion. Clinical, biological and morphological data were collected. We compared cardiac parameters and MSNA before and after administration of levosimendan. 13 patients were recruited (48 +/- 3.6 years). Systolic blood pressure and rate pressure product (mmHg x Beat/min) decreased significantly after levosimendan infusion (P< 0.05). Cardiac output and stroke volume were significantly increased after levosimendan infusion (P< 0.05). A significant decrease of MSNA activity is observed after levosimend...Continue Reading

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Citations

Oct 7, 2011·Current Treatment Options in Cardiovascular Medicine·David T Majure, John R Teerlink
Dec 17, 2015·The American Journal of Emergency Medicine·Giolanda VarvarousiHlias Pavlou
Apr 19, 2013·Journal of Clinical Pharmacy and Therapeutics·A PathakF Despas
Jul 10, 2021·Cardiovascular Research·Guido GrassiMurray Esler

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