title: Preconditioning effects of levosimendan in coronary artery bypass grafting--a pilot study.
abstract: BACKGROUND
  The calcium sensitizer levosimendan protects against myocardial ischaemia and reperfusion injury in animal models.
  
  
  METHODS
  The present pilot study investigated whether a short infusion before coronary artery bypass grafting (CABG) would protect the myocardium and improve postoperative haemodynamics. Twenty-four patients with stable angina undergoing elective CABG surgery were randomized to receive either placebo or levosimendan (24 microg kg(-1)) infused i.v. over a 10 min period just before placing the patient on cardiopulmonary bypass.
  
  
  RESULTS
  Perioperative haemodynamic variables, concentrations of cardiac troponin I over the 48 h postoperative period, and clinical outcomes were assessed. There were no adverse effects related to levosimendan. Compared with control patients, levosimendan-treated patients had lower postoperative troponin I concentrations (P<0.05) and a higher cardiac index (P<0.05).
  
  
  CONCLUSIONS
  Patients receiving a short infusion of levosimendan before CABG showed evidence of less myocardial damage, suggestive of a preconditioning effect. Larger outcome studies are thus indicated to confirm benefit.
authors.affiliation: Department of Anesthesiology and Intensive Care, University of Rome La Sapienza, Rome, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Tritapepe
authors.forename: V
authors.initials: V
authors.lastname: De Santis
authors.forename: D
authors.initials: D
authors.lastname: Vitale
authors.forename: M
authors.initials: M
authors.lastname: Santulli
authors.forename: A
authors.initials: A
authors.lastname: Morelli
authors.forename: I
authors.initials: I
authors.lastname: Nofroni
authors.forename: P E
authors.initials: PE
authors.lastname: Puddu
authors.forename: M
authors.initials: M
authors.lastname: Singer
authors.forename: P
authors.initials: P
authors.lastname: Pietropaoli
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control; D010865:Pilot Projects; D011300:Preoperative Care / Q000379:methods; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D019210:Troponin I; D000077464:Simendan