Effects of a new calcium sensitizer, levosimendan, on haemodynamics, coronary blood flow and myocardial substrate utilization early after coronary artery bypass grafting

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Abstract
Aims The aim of the study was to evaluate the effects on systemic and coronary haemodynamics and myocar-dial substrate utilization of a new calcium sensitizer, levosimendan, after coronary artery bypass grafting. Methods and Results Twenty-three low-risk patients were included in this randomized and double-blind study. They received placebo (n=8), 8 (n=8) or 24 (n=7) μg.kg−1of levosimendan after coronary artery bypass operation. Systemic and coronary sinus haemodynamics with thermodilution and myocardial substrate utilization were measured. The heart rate increased 11 beats.min−1after the higher dose (P−1(P−1of levosimendan, respectively. Systemic and pulmonary vascular resistance decreased significantly after both doses. Coronary sinus blood flow increased by 28 and 42ml/(P=0·054 for the combined effect) after the lower and higher dose, respectively. Myocardial oxygen consumption or substrate extractions did not change statistically significantly. Conclusion Despite improved cardiac performance, levosimendan did not increase myocardial oxygen con-sumption or change myocardial substrate utilization. Thus levosimendan has the potential to treat low cardiac output states after cardiopulmonary bypass surgery.

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