title: Effect of levosimendan therapy on myocardial infarct size and left ventricular function after acute coronary occlusion.
abstract: BACKGROUND
  Levosimendan is an inotropic agent with cardioprotective and vasodilating properties used for the management of acutely decompensated heart failure. We studied the effects of levosimendan treatment on the size of myocardial infarction (MI) and left ventricular (LV) function in experimental pig model of post MI heart failure.
  
  
  METHODS
  After occlusion of the left anterior descending (LAD) coronary artery, animals received levosimendan 5 mg/kg/day orally for 8 weeks (n=7) or no treatment (n=18). One week after stopping treatment, transthoracic echocardiography, CT scan and positron emission tomography were performed to evaluate myocardial function, perfusion and oxidative metabolism. Histology was used to confirm the size of MI and features of LV remodelling.
  
  
  RESULTS
  The size of MI was significantly smaller in the levosimendan group than in the controls (12±13% vs 27±15% of the LV, p=0.03). End-diastolic volume (EDV) and end-systolic volume (ESV) were smaller in the levosimendan than in the control group (EDV 161±29 mL vs 245±84 mL, p=0.06; ESV 81±18 mL vs 149±67 mL, p=0.03), whereas ejection fraction tended to be higher in the levosimendan group (50±6% vs 41±8%, p=0.06).
  
  
  CONCLUSIONS
  Eight weeks of levosimendan therapy after recent LAD occlusion decreases the size of MI and leads to better preservation of LV function as well as reduced LV remodelling.
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland Department of Pharmacology, University of Helsinki, Helsinki, Finland.
authors.forename: Miikka
authors.initials: M
authors.lastname: Tarkia
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Stark
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Haavisto
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Kentala
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Tommi
authors.initials: T
authors.lastname: Vähäsilta
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Savunen
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Marjatta
authors.initials: M
authors.lastname: Strandberg
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Virva
authors.initials: V
authors.lastname: Saunavaara
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Tolvanen
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Teräs
authors.affiliation: Heart Center, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Mikko
authors.initials: M
authors.lastname: Pietilä
authors.affiliation: Orion Corporation Orion Pharma, Espoo, Finland.
authors.forename: Leena
authors.initials: L
authors.lastname: Nyman
authors.affiliation: Quotient Bio Analytical Sciences, Fordham, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Duvall
authors.affiliation: Department of Forensic Medicine, University of Turku, Turku, Finland.
authors.forename: Pekka
authors.initials: P
authors.lastname: Saukko
authors.affiliation: Orion Corporation Orion Pharma, Espoo, Finland.
authors.forename: Jouko
authors.initials: J
authors.lastname: Levijoki
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland Turku Center for Disease Modeling, University of Turku, Turku, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Roivainen
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland Heart Center, Turku University Hospital and University of Turku, Turku, Finland Institute of Clinical Medicine, University of Turku, Turku, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Saraste
authors.affiliation: Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Knuuti
mesh_terms: D000208:Acute Disease; D000818:Animals; D002316:Cardiotonic Agents / Q000627:therapeutic use; D054059:Coronary Occlusion / Q000150:complications*; D003971:Diastole; D004195:Disease Models, Animal; D005500:Follow-Up Studies; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D009200:Myocardial Contraction / Q000187:drug effects* / Q000502:physiology; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D013552:Swine; D013599:Systole; D016277:Ventricular Function, Left / Q000187:drug effects* / Q000502:physiology; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan