title: Levosimendan in off-pump coronary artery bypass: a four-times masked controlled study.
abstract: We tested the hypothesis that levosimendan produced beneficial hemodynamic effects during and after off-pump coronary artery bypass grafting in patients with good preoperative left ventricular function. Levosimendan at low dose (12 microg/kg), high dose (24 microg/kg), or placebo were administered in thirty-one patients in a randomized and four-times masked controlled study. Heart rate was not significantly different between experimental groups. Significant increases in cardiac output and left ventricular ejection fraction occurred after high-dose (P < 0.001; P = 0.006) and low-dose levosimendan (P = 0.001; P = 0.002). Both doses of levosimendan produced significant increased stroke volume and decreased systemic vascular resistance. Mean arterial pressure, pulmonary capillary wedge pressure, and left ventricular end-systolic volume were not significantly different between groups. The low-dose levosimendan produced better hemodynamic response than high-dose and may be preferable in patients undergoing off-pump coronary artery bypass grafting.
authors.affiliation: Clinical Department of Anesthesiology, Reanimatology, and Intensive Care Medicine, University Hospital Dubrava, Zagreb, Croatia. abarisin@kbd.hr
authors.forename: Stjepan
authors.initials: S
authors.lastname: Barisin
authors.forename: Ino
authors.initials: I
authors.lastname: Husedzinovic
authors.forename: Zdenko
authors.initials: Z
authors.lastname: Sonicki
authors.forename: Nikola
authors.initials: N
authors.lastname: Bradic
authors.forename: Ana
authors.initials: A
authors.lastname: Barisin
authors.forename: Dinko
authors.initials: D
authors.lastname: Tonkovic
mesh_terms: D000758:Anesthesia; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000601:surgery; D001026:Coronary Artery Bypass; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan