Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2014 Jan-Feb;46(1):29-34.
doi: 10.4103/0253-7613.125161.

Study of levosimendan during off-pump coronary artery bypass grafting in patients with LV dysfunction: a double-blind randomized study

B Shah  1 , P Sharma  1 , A Brahmbhatt  1 , R Shah  1 , B Rathod  1 , Naman Shastri  1 , J Patel  1 , A Malhotra  1
Affiliations
Randomized Controlled Trial

Study of levosimendan during off-pump coronary artery bypass grafting in patients with LV dysfunction: a double-blind randomized study

B Shah et al. Indian J Pharmacol. 2014 Jan-Feb.

Abstract

Objectives: Levosimendan is a calcium sensitizer drug which has been used in cardiac surgery for the prevention of postoperative low cardiac output syndrome (LCOS) and in difficult weaning from cardiopulmonary bypass (CPB). This study aims to evaluate perioperative hemodynamic effects of levosimendan pretreatment in patients for off-pump coronary artery bypass graft (OPCABG) surgery with low left ventricular ejection fractions (LVEF < 30%).

Materials and methods: Fifty patients undergoing OPCABG surgery with low LVEF (<30%) were enrolled in the study. Patients were randomly divided in two groups: Levosimendan pretreatment (Group L) and placebo pretreatment (Group C) of 25 each. Group L, patients received levosimendan infusion 200 μg/kg over 24 h and in Group C Patients received placebo. The clinical parameters measured before and after the drug administration up to 48 h were heart rate (HR; for the hour after drug infusion), cardiac index (CI), and pulmonary capillary wedge pressure (PCWP). The requirement of inotropes, intraaortic balloon pump (IABP), CPB, intensive care unit (ICU) stay, and hospital stay were also measured.

Results: The patients in group L exhibited higher CI and PCWP during operative in early postoperative period as compared to control group C. Group L also had a less requirement for inotropes, CPB support and IABP with shorter ICU stay as well as hospital stay.

Conclusion: Levosimendan pretreatment (24 h infusion) in patient for OPCABG with poor LVEF shows better outcomes and hemodynamics in terms of inotropes, CPB and IABP requirements. It also reduces ICU stay.

Keywords: CPB; Cardiac index; LCOS; OPCABG surgery; hemodynamic optimization; inotropic agents; levosimendan; off-pump coronary artery bypass graft; pulmonary capillary wedge pressure.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared

References

    1. Lehmann A, Boldt J, Kirchner J. The role of Ca++ -sensitizers for the treatment of heart failure. Curr Opin Crit Care. 2003;9:337–44. - PubMed
    1. Haikala H, Nissinen E, Etemadzadeh E, Levijoki J, Linden IB. Troponin C-mediated calcium sensitization induced by levosimendan does not impair relaxation. J Cardiovasc Pharmacol. 1995;25:794–801. - PubMed
    1. Toller WG, Stranz C. Levosimendan, a new inotropic and vasodilator agent. Anesthesiology. 2006;104:556–69. - PubMed
    1. Zinovic IH, Zinovic SH, Milanovic R. Levosimendan in acute heart failure. Signa Vitae. 2008;3(Suppl 1):S13–6.
    1. Liu T, Li G, Xu G. Levosimendan may prevent postoperative atrial fibrillation through anti-inflammatory and antioxidant modulation. J Cardiothorac Vasc Anesth. 2009;23:757–8. - PubMed

Publication types