title: Effects of levosimendan on left ventricular diastolic function after primary angioplasty for acute anterior myocardial infarction: a Doppler echocardiographic study.
abstract: BACKGROUND
  Levosimendan is a new Ca-sensitizing drug with combined positive inotropic and vasodilatory effects that offers new therapeutic possibilities in patients with severe heart failure. Compared with other inotropic agents, animal studies demonstrated that levosimendan does not impair left ventricular diastolic function.
  
  
  OBJECTIVE
  We sought to evaluate the effects of levosimendan on left ventricular diastolic function, using conventional transmitral Doppler and Doppler tissue imaging parameters, in patients with anterior acute myocardial infarction undergoing primary angioplasty.
  
  
  METHODS
  After a successful primary angioplasty, we randomized 52 consecutive patients with anterior acute myocardial infarction to levosimendan or placebo infusion and analyzed the diastolic function using conventional transmitral Doppler flow and Doppler tissue imaging at mitral annulus.
  
  
  RESULTS
  At 24 hours after the index intervention, patients treated with levosimendan (n = 26) showed a significant reduction of the isovolumetric relaxation time (114.6 +/- 15.1-69.2 +/- 5.6 milliseconds; P = .001) and the ratio between the early diastolic flow and early tissue velocity (E/E') (21.4 +/- 10.7-12.8 +/- 7.3; P = .04), and a significant increase of the ratio between the early and late diastolic flow (E/A) (0.86 +/- 0.33-1.52 +/- 0.88; P = .03) and E' (6.4-7.9 cm/s; P = .001). On the other hand, only a significant increase in E/A ratio (0.97 +/- 0.32-1.64 +/- 0.51; P = .002) was observed in the placebo group (n = 26).
  
  
  CONCLUSIONS
  Levosimendan, after primary angioplasty in patients with anterior acute myocardial infarction, appears to improve the Doppler echocardiographic parameters of left ventricular diastolic function.
authors.affiliation: Department of Cardiovascular and Respiratory Sciences, La Sapienza University, Rome, Italy. leodeluca@virgilio.it
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Paola
authors.initials: P
authors.lastname: Proietti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Battagliese
authors.forename: Giulia
authors.initials: G
authors.lastname: Benedetti
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Roma
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
mesh_terms: D000800:Angioplasty, Balloon; D002316:Cardiotonic Agents / Q000008:administration & dosage; D015150:Echocardiography, Doppler / Q000379:methods*; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery*; D011379:Prognosis; D011724:Pyridazines / Q000008:administration & dosage*; D000077464:Simendan; D013318:Stroke Volume / Q000187:drug effects; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D014665:Vasodilator Agents; D000077464:Simendan