REVIEW Levosimendan is a calcium sensitiser. It increases the sensitivity of the heart to calcium, thus increasing cardiac contractility without a rise in intracellular calcium. Levosimendan exerts its positive inotropic effect by increasing calcium sensitivity of myocytes by binding to cardiac troponin C in a calcium-dependent manner. It also has a vasodilatory effect, by opening adenosine triphosphate (ATP)-sensitive potassium channels in vascular smooth muscle to cause smooth muscle relaxation. The combined inotropic and vasodilatory actions result in an increased force of contraction, decreased preload and decreased afterload.
REFERENCES
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Plaschke K, Bent F, Rosenhagen C, Wagner S, Hofer S, Kopitz J (2012). The inhibitory in-vitro effect of high-dose levosimendan on platelet function may be mediated through its action as a phosphodiesterase inhibitor. Coron Artery Dis. 23(3):215-20. PMID 22343797.
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Memis D, Inal MT, Sut N (2012). The effects of levosimendan vs dobutamine added to dopamine on liver functions assessed with noninvasive liver function monitoring in patients with septic shock. J Crit Care. 27(3):318.e1-6. PMID 21855289.
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