Key result
Levosimendan administration improved indices of systolic and diastolic cardiac function and restored plasma levels of GSH and TBARS in 4 patients with cardiogenic shock or low cardiac output.
Why the study?
Levosimendan's beneficial effects against cardiac failure could relate to oxidative balance modulation, prompting evaluation of its effects in cardiogenic shock or low cardiac output.
Does levosimendan infusion improve cardiac function and oxidative balance in patients with cardiogenic shock or low cardiac output?
Observational (n=4)
Does levosimendan infusion improve cardiac function and oxidative balance in patients with cardiogenic shock or low cardiac output?
Levosimendan improves cardiac function and restores oxidative balance in patients with cardiogenic shock or low cardiac output, suggesting a potential mitochondrial mechanism of cardioprotection.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating in cardiogenic shock; randomized trials needed before clinical consideration.
The beneficial effects exerted by levosimendan against cardiac failure could be related to the modulation of oxidative balance. We aimed to examine the effects of levosimendan in patients with cardiogenic shock or low cardiac output on cardiac systo-diastolic function and plasma oxidants/antioxidants (glutathione, GSH; thiobarbituric acid reactive substances, TBARS). In four patients undergoing coronary artery bypass grafting or angioplasty, cardiovascular parameters and plasma GSH and TBARS were measured at T0 (before levosimendan infusion), T1 (1 h after the achievement of the therapeutic dosage of levosimendan), T2 (end of levosimendan infusion), T3 (72 h after the end of levosimendan infusion), and T4 (end of cardiogenic shock). We found an improvement in the indices of systolic (ejection fraction, cardiac output, cardiac index) and diastolic (E to early diastolic mitral annular tissue velocity, E/'; early to late diastolic transmitral flow velocity, EA) cardiac function at early T2. A reduction of central venous pressure and pulmonary wedge pressure was also observed. Plasma levels of GSH and TBARS were restored by levosimendan at T1, as well. The results obtained indicate that levosimendan administration can regulate oxidant/antioxidant balance as an early effect in cardiogenic shock/low cardiac output patients. Modulation of oxidative status on a mitochondrial level could thus play a role in exerting the cardio-protection exerted by levosimendan in these patients.
No takes yet. Share an insight, caveat, or question.
Grossini et al. (2020) conducted an observational in Cardiogenic shock or low cardiac output (n=4). Levosimendan was evaluated on Cardiac systo-diastolic function and plasma oxidants/antioxidants (GSH, TBARS). Levosimendan administration improved indices of systolic and diastolic cardiac function and restored plasma levels of GSH and TBARS in 4 patients with cardiogenic shock or low cardiac output.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: