Levosimendan as a new strategy during off-pump coronary artery bypass grafting: double-blind randomized placebo-controlled trial.
OBJECTIVE
To determine if levosimendan could improve cardiac performance during off-pump coronary artery bypass grafting in patients with normal preoperative left ventricular function.


METHODS
Twenty-four patients included in this double-blind randomized controlled trial received either placebo (n=12) or 12 microg/kg loading dose of levosimendan (n=12) during a period of 15 minutes before the surgery. The heart rate, cardiac index, stroke volume index, and left ventricular ejection fraction were measured before and 10 and 60 minutes after the drug administration.


RESULTS
The baseline measurements of hemodynamic parameters did not differ between the groups. Heart rate was not significantly different between the placebo and levosimendan group. Compared with placebo group, cardiac index and left ventricular ejection fraction were significantly higher 10 and 60 minutes (p=0.018 for all) after administration of levosimendan. After 60 minutes, the cardiac index increased from the baseline value of 2.18 to 2.84 L/min/m2. Left ventricular ejection fraction increased by 14% after 10 minutes, and by 10% after 60 minutes. Stroke volume index was significantly higher at 10 minutes (p=0.018), but not at 60 minutes (p=0.063) after the administration of levosimendan.


CONCLUSIONS
Administration of 12 microg/kg of levosimendan enhances the left ventricular performance and offers a promising therapeutic option during off-pump coronary artery bypass grafting in patients with good preoperative left ventricular function.
Husedzinović
Ino
I
Department for Anesthesiology, Reanimatology and Intensive Care Medicine, Dubrava University Hospital, Av. Gojka Suska 6, 10000 Zagreb, Croatia. inoh@kbd.hr
Barisin
Stjepan
S
Bradić
Nikola
N
Barisin
Ana
A
Sonicki
Zdenko
Z
Milanović
Rudolf
R
D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003326:Coronary Circulation / Q000187:drug effects; D004311:Double-Blind Method; D006439:Hemodynamics; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan; D013318:Stroke Volume / Q000187:drug effects; D019209:Troponin C / Q000187:drug effects
D002316:Cardiotonic Agents; D006835:Hydrazones; D010919:Placebos; D011724:Pyridazines; D019209:Troponin C; D000077464:Simendan