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European Heart Journal Advance Access published online on April 27, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi875
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European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received January 10, 2006
Revised March 15, 2006
Accepted March 23, 2006

Review

Evidence-based use of levosimendan in different clinical settings

Leonardo De Luca 1, Wilson S. Colucci 2, Markku S. Nieminen 3, Barry M. Massie 4, and Mihai Gheorghiade 5 *

1 Division of Cardiology, European Hospital, Rome, Italy
2 Cardiovascular Medicine Section, Boston University Medical Center, Boston, MA, USA
3 Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
4 Section of Cardiology, San Francisco Veterans Affairs Medical Center and School of Medicine, University of California, San Francisco, CA, USA
5 Division of Cardiology, Northwestern University, Feinberg School of Medicine Galter 10-240, 201 E. Huron Street, Chicago, IL 60611, USA

* To whom correspondence should be addressed.
Mihai Gheorghiade, E-mail: m-gheorghiade{at}northwestern.edu


  Abstract

Levosimendan is a new calcium sensitizer and K-ATP channel opener. Compared with other inodilators, it improves myocardial contractility without increasing oxygen requirements and induces peripheral and coronary vasodilation with a potential anti-stunning, anti-ischaemic effect. The documentation regarding levosimendan is one of the largest ever on the safety and efficacy of a new pharmacological agent in acute heart failure syndromes. Recent experiences in small-scale studies and randomized clinical trials have led to greater interest in the use of this drug for the support of impaired cardiac function also in patients with ischaemic heart disease and cardiogenic or septic shock. It is also demonstrated that this drug could be used as bridge therapy for the peri-operative phase of cardiac surgery in both adult and paediatric populations. This review summarizes the evidence from published scientific literature regarding the use of levosimendan in various clinical settings.

Keywords: Levosimendan; Calcium sensitizers; Inotropic agents; Heart failure; Cardiac surgery; Ischaemic heart disease; Cardiogenic shock.
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