title: Levosimendan: from basic science to clinical trials.
abstract: Levosimendan is one of the documented pharmacological agents used in the management and treatment of acute and chronic heart failure; it is a novel inodilator agent which enhanced myocardial performance without changes in oxygen consumption. The combination of positive inotropic and vasodilator effects of levosimendan relates to its Ca(2+) - sensitizing and K(+) channels opening effects. Levosimendan has been proposed, in the recent past, to be non-inferior and may have some advantages to standard inotropes; further possible indications for levosimendan have been described, in some observational studies, such as a perioperative use, cardioprotection, cardiogenic shock, sepsis and right ventricular dysfunction. The ability of levosimendan to improve myocardial function without substantially increasing oxygen consumption may appear paradoxical but is possible via improved efficacy not only with regard to the effects on the contractile apparatus of the cardiomyocytes. The aim of this review is to describe the pharmacological characteristics of levosimendan and its clinical applications. The patent review data regarding the use of levosimendan are also discussed in this review article.
authors.affiliation: Coronary Care Unit, Hospital Maggiore della Carità, Novara, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rognoni
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lupi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Lazzero
authors.forename: Angelo S
authors.initials: AS
authors.lastname: Bongo
authors.forename: Giorgio
authors.initials: G
authors.lastname: Rognoni
mesh_terms: D000208:Acute Disease; D000818:Animals; D015220:Calcium Channels / Q000187:drug effects / Q000378:metabolism; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006835:Hydrazones / Q000009:adverse effects / Q000627:therapeutic use*; D009200:Myocardial Contraction / Q000187:drug effects; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption; D015221:Potassium Channels / Q000187:drug effects / Q000378:metabolism; D011724:Pyridazines / Q000009:adverse effects / Q000627:therapeutic use*; D000077464:Simendan; D057170:Translational Research, Biomedical; D016896:Treatment Outcome; D016276:Ventricular Function / Q000187:drug effects
chemical_list: D015220:Calcium Channels; D002317:Cardiovascular Agents; D006835:Hydrazones; D015221:Potassium Channels; D011724:Pyridazines; D000077464:Simendan