Key result
Levosimendan, but not milrinone, significantly attenuated ventricular premature beats (-63%), tachycardia (-50%), and fibrillation (-70%) during and after regional myocardial ischemia in dogs.
Why the study?
Does levosimendan reduce ischemia/reperfusion-induced arrhythmias compared to milrinone in a canine model?
Does levosimendan reduce ischemia/reperfusion-induced arrhythmias compared to milrinone in a canine model?
In a canine model of ischemia/reperfusion, levosimendan was associated with significantly fewer ventricular arrhythmias and improved survival compared to milrinone.
Hypothesis-generating in canine ischemia; does not support clinical use and requires human trials.
Phosphodiesterase inhibitors as inodilators in heart failure are associated with promotion of arrhythmias. Calcium sensitizers have been proposed for the treatment of severe decompensated heart failure. The effect of levosimendan, a calcium sensitizer, and milrinone, a phosphodiesterase inhibitor, on ventricular arrhythmias was compared in a model of acute regional myocardial ischemia and reperfusion. The left anterior descending coronary artery in dogs was occluded for 25 minutes, followed by reperfusion. The 2 drugs were administered in a hemodynamically equieffective dose (0.1 micromol/kg) 10 minutes before coronary occlusion. Levosimendan, but not milrinone, significantly attenuated the pronounced increase in the number of ventricular premature beats (-63%), tachycardia (-50%), fibrillation (-70%), and inhomogeneity of ventricular electrical activation. Levosimendan significantly improved the overall survival rate. Levosimendan has a more beneficial profile than milrinone regarding the development of ventricular arrhythmias during and after regional myocardial ischemia.
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Papp et al. (2006) studied Acute regional myocardial ischemia and reperfusion-induced arrhythmias. Levosimendan vs. Milrinone was evaluated on Ventricular arrhythmias (ventricular premature beats, tachycardia, fibrillation). Levosimendan, but not milrinone, significantly attenuated ventricular premature beats (-63%), tachycardia (-50%), and fibrillation (-70%) during and after regional myocardial ischemia in dogs.
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