title: Long-term effects of levosimendan infusion on inflammatory processes and sFas in patients with severe heart failure.
abstract: BACKGROUND
  The calcium sensitizer levosimendan improves myocardial contractility in patients with heart failure, although its effects on inflammation and apoptosis are unknown.
  
  
  OBJECTIVE
  To examine the effects of levosimendan on markers of inflammation and apoptosis, over a period of 30 d following a 24 h infusion, in patients with heart failure.
  
  
  METHODS
  Thirty four patients with severe heart failure were randomised to receive a 24 h infusion of levosimendan or placebo, in a double-blind trial. Haemodynamic evaluation and blood sampling were performed at baseline, 24 h, 30 h, 48 h, 7 d and 30 d after the end of the infusion.
  
  
  RESULTS
  Seven patients (1 levosimendan, 6 placebo), were excluded during follow-up. In the remaining 27 patients, levosimendan decreased serum IL-6 and sFAS, 24 h after the infusion (p<0.01 and p<0.05 vs baseline), an effect sustained for 7-30 d. Serum TNF-alpha and sTNF-R1 were decreased between 48 h (p<0.01 vs baseline for both) and 7 d (p<0.05 vs baseline for sTNF-R1) after infusion. Serum sTNF-R2 was decreased at 24 h (p<0.05 vs baseline) and remained lower than baseline for at least 7 d (p<0.05).
  
  
  CONCLUSIONS
  These findings indicate that levosimendan decreases the expression of proinflammatory cytokines, TNF-alpha receptors and sFAS, immediately after infusion, an effect which persists for 7-30 d.
authors.affiliation: Athens University Medical School, A' Cardiology Department, Athens, Greece. atrikas@otenet.gr
authors.forename: Athanasios
authors.initials: A
authors.lastname: Trikas
authors.forename: Charalambos
authors.initials: C
authors.lastname: Antoniades
authors.forename: Giorgos
authors.initials: G
authors.lastname: Latsios
authors.forename: Karmen
authors.initials: K
authors.lastname: Vasiliadou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karamitros
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tousoulis
authors.forename: Costantinos
authors.initials: C
authors.lastname: Tentolouris
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D007249:Inflammation / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D007263:Infusions, Parenteral; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D011724:Pyridazines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000378:metabolism; D000077464:Simendan; D012995:Solubility; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019014:fas Receptor / Q000378:metabolism*
chemical_list: D006835:Hydrazones; D015850:Interleukin-6; D011724:Pyridazines; D047888:Receptors, Tumor Necrosis Factor, Type I; D014409:Tumor Necrosis Factor-alpha; D019014:fas Receptor; D000077464:Simendan