Early and Preventive Use of Levosimendan in Patients with Ventricular Dysfunction

European Heart Journal Cardiovascular Pharmacotherapy

15 November Nov 2019 4 months ago
  • Cosentino N, Agostoni P, Marenzi G

Acute ventricular dysfunction is a complex condition with substantial morbidity and mortality, still featuring unique therapeutic challenges. Levosimendan is a calcium sensitizer and ATP-dependent potassium channel opener that was developed as an inodilating drug for the treatment of acute heart failure and cardiogenic shock.

Differently from other more widely used inotropic agents, levosimendan has some exclusive characteristics, in terms of mechanisms of action, pharmacodynamic profile, and hemodynamic effects. This may have important clinical implications.

In particular, in patients with acute ventricular dysfunction or in patients with pre-existing severe ventricular impairment undergoing planned myocardial stress, the administration of levosimendan before the onset of overt symptoms or before cardiovascular therapeutic procedures may have the potential to bridge the patient through the critical phase.

In this review, the Authors focused on the rationale, the existing experimental data, and the emerging clinical experience supporting an early, even preventive use of levosimendan in severe ventricular dysfunction, beyond its recognized indications.

1. Cosentino N, Niccoli G, Fracassi F, Rebuzzi A, Agostoni P, Marenzi G. Rationale, Experimental Data, and Emerging Clinical Evidence on Early and Preventive Use of Levosimendan in Patients with Ventricular Dysfunction. Eur Heart J Cardiovasc Pharmacother 2019 Nov 5. pii: pvz065. doi: 10.1093/ehjcvp/pvz065. Go to PubMed