ICVTS on-line discussion A
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《血管的通路杂志》
PSHC, King Fahd Medical City, Riyadh, Saudi Arabia
Levosimendan for patients with impaired left ventricular function undergoing cardiac surgery
eComment: 1. I think the observed effect of levosimendan in increasing CI [1] is simply due to its chronotropic effect by increasing the heart rate, and its vasodilating effect by reducing the elevated SVR. Both of these 2 effects could have been simply achieved by a combination of a vasodilator and chronotropic agents.
2. The definition of impaired left ventricular function should include patients with EF<30%. Likewise, the definition of low cardiac output syndrome should mean CI<2 L/m2/min. So to find a true significant benefit for levosimendan, it should be tested in patients with truly poor LV function and low output syndrome.
References
Tokuda Y, Grant PW, Wolfenden HD, Manganas C, Lyon WJ, Murala JSK. Levosimendan for patients with impaired left ventricular functionundergoing cardiac sugery. Interact CardioVasc Thorac Surg 2006; 5:322–326.
Related Article
Levosimendan for patients with impaired left ventricular function undergoing cardiac surgery
Yoshiyuki Tokuda, Peter W. Grant, Hugh D. Wolfenden, Con Manganas, William J. Lyon, and John S.K. Murala
Interactive CardioVascular and Thoracic Surgery 2006 5: 322-326. [Full Text](Mohamed Fahmy Ibrahim)
Levosimendan for patients with impaired left ventricular function undergoing cardiac surgery
eComment: 1. I think the observed effect of levosimendan in increasing CI [1] is simply due to its chronotropic effect by increasing the heart rate, and its vasodilating effect by reducing the elevated SVR. Both of these 2 effects could have been simply achieved by a combination of a vasodilator and chronotropic agents.
2. The definition of impaired left ventricular function should include patients with EF<30%. Likewise, the definition of low cardiac output syndrome should mean CI<2 L/m2/min. So to find a true significant benefit for levosimendan, it should be tested in patients with truly poor LV function and low output syndrome.
References
Tokuda Y, Grant PW, Wolfenden HD, Manganas C, Lyon WJ, Murala JSK. Levosimendan for patients with impaired left ventricular functionundergoing cardiac sugery. Interact CardioVasc Thorac Surg 2006; 5:322–326.
Related Article
Levosimendan for patients with impaired left ventricular function undergoing cardiac surgery
Yoshiyuki Tokuda, Peter W. Grant, Hugh D. Wolfenden, Con Manganas, William J. Lyon, and John S.K. Murala
Interactive CardioVascular and Thoracic Surgery 2006 5: 322-326. [Full Text](Mohamed Fahmy Ibrahim)