title: Early and sustained haemodynamic improvement with levosimendan compared to intraaortic balloon counterpulsation (IABP) in cardiogenic shock complicating acute myocardial infarction.
abstract: OBJECTIVE
  To investigate the haemodynamic effects of levosimendan in patients with cardiogenic shock (CS) complicating acute myocardial infarction in comparison to the effects of intra-aortic balloon counterpulsation (IABP).
  
  
  METHODS
  10 patients with intractable CS under standard therapy (including the use of PCI, inotropes, and vasopressors) received i.v. infusion of levosimendan (bolus 12 microg/kg i.v., followed by continuous infusion 0.1 microg/kg/min for 24 h). Haemodynamic effects were compared to the effects of IABP-placement added to standard care in 12 patients with CS.
  
  
  RESULTS
  Within 24 h, both levosimendan and IABP produced a significant increase in cardiac index (CI) and cardiac power index and a decrease in systemic vascular resistance (SVR) (CI [l/min/m2] baseline 1.97+/-0.15, at 24 h 2.82+/-0.22 for levosimendan; baseline 1.98+/-0.17, at 24 h 2.66+/-0.08 for IABP; SVR [dyn*s*cm-5] baseline 1353+/-106, at 24 h 846+/-69 for levosimendan; baseline 1311+/-214, at 24 h 853+/-63 for IABP, respectively). After 3 h of treatment, CI and SVR had significantly improved in patients treated with levosimendan but not in the IABP-group (CI [l/min/m2] at 3 h 2.72+/-0.28 (+38%) for levosimendan versus 2.18+/-0.15 (+10%) for IABP).
  
  
  CONCLUSIONS
  Infusion of levosimendan in acute CS results in early and sustained haemodynamic improvement. Short-term haemodynamic effects compare favourably with those seen after invasive IABP placement.
authors.affiliation: Department of Medicine III, Martin Luther-University Halle-Wittenberg, Germany.
authors.forename: Arnd
authors.initials: A
authors.lastname: Christoph
authors.forename: Roland
authors.initials: R
authors.lastname: Prondzinsky
authors.forename: Martin
authors.initials: M
authors.lastname: Russ
authors.forename: Matthias
authors.initials: M
authors.lastname: Janusch
authors.forename: Axel
authors.initials: A
authors.lastname: Schlitt
authors.forename: Henning
authors.initials: H
authors.lastname: Lemm
authors.forename: Sebastian
authors.initials: S
authors.lastname: Reith
authors.forename: Karl
authors.initials: K
authors.lastname: Werdan
authors.forename: Michael
authors.initials: M
authors.lastname: Buerke
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002316:Cardiotonic Agents / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006835:Hydrazones / Q000494:pharmacology*; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D011651:Pulmonary Artery / Q000503:physiopathology; D011724:Pyridazines / Q000494:pharmacology*; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D000077464:Simendan; D013997:Time Factors; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan