Faculty Collaboration Database

Intracoronary levosimendan enhances contractile function of stunned myocardium. Anesth Analg 1997 Jul;85(1):23-9

Date

07/01/1997

Pubmed ID

9212117

DOI

10.1097/00000539-199707000-00005

Scopus ID

2-s2.0-0030857836 (requires institutional sign-in at Scopus site)   108 Citations

Abstract

A decrease in myofilament sensitivity to Ca2+ has been proposed as a mechanism for reversible contractile dysfunction after ischemia and reperfusion. The direct actions of intracoronary myofilament Ca2+ sensitizers on stunned myocardium have not been examined. Barbiturate-anesthetized dogs (n = 9) were instrumented for measurement of left ventricular (LV) and aortic blood pressure, cardiac output, left anterior descending coronary artery (LAD) blood flow velocity, and subendocardial segment length (percent segment shortening [%SS]). Dogs were subjected to five 5-min LAD occlusions interspersed by 5-min reperfusions. Three hours after the final reperfusion, levosimendan (1.5, 3, 6, and 12 microg/min) was administered via an intracoronary catheter. Hemodynamic effects and regional myocardial function were determined under control conditions, during each LAD occlusion and reperfusion, 3 h after final reperfusion, and after 10 min equilibration at each dose of levosimendan. Three hours after the final reperfusion, %SS and the ratio of effective to total regional work were significantly (P < 0.05) decreased, and postsystolic shortening area was increased, consistent with myocardial stunning. In stunned myocardium, intracoronary levosimendan caused dose-dependent increases in %SS (2 +/- 1 at 3 h after reperfusion to 13% +/- 2% during 12 microg/min), abolished postsystolic shortening area, and restored the ratio of effective to total regional work while producing minimum systemic hemodynamic effects.

Author List

Jamali IN, Kersten JR, Pagel PS, Hettrick DA, Warltier DC

Authors

Paul S. Pagel PhD, MS, MD Emeritus Professor in the Anesthesiology department at Medical College of Wisconsin
David C. Warltier PhD Emeritus Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Animals
Cardiotonic Agents
Coronary Vessels
Dogs
Dose-Response Relationship, Drug
Hemodynamics
Hydrazones
Myocardial Contraction
Myocardial Stunning
Phosphodiesterase Inhibitors
Pyridazines