Kasikcioglu Hulya Akhan, Cam Nese
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Vasc Health Risk Manag. 2006;2(4):389-400. doi: 10.2147/vhrm.2006.2.4.389.
Heart failure is a relatively important public health problem due to its increasing incidence, poor prognosis, and frequent need of re-hospitalization. Intravenous positive inotropic agents play an important role in treating acute decompensation of patients with heart failure due to left ventricular systolic dysfunction. Although frequently used, the inotropic agents beta-adrenergic agonists and phosphodiesterase inhibitors seem effective for improving symptoms in the short term; it has been shown that they increase morbidity and mortality by elevating intracellular cyclic adenosine monophosphate (cAMP) and calcium levels. Levosimendan is a new positive inotropic agent having ATP-dependent potassium-channel-opening and calcium-sensitizing effects. In studies on its effects without increasing intracellular calcium concentrations and on its effects that depend on available intracellular calcium levels, it has been shown to have favorable characteristics different from those of current inotropic agents, which exert their effects by increasing calcium concentrations. This study aims to review other important studies about levosimendan by revealing the underlying mechanisms of its activity, efficiency, and safety.
由于心力衰竭的发病率不断上升、预后较差且频繁需要再次住院，它是一个较为重要的公共卫生问题。静脉注射正性肌力药物在治疗因左心室收缩功能障碍导致心力衰竭的患者急性失代偿方面发挥着重要作用。尽管正性肌力药物β-肾上腺素能激动剂和磷酸二酯酶抑制剂经常使用，它们似乎在短期内对改善症状有效；但已表明它们通过提高细胞内环磷酸腺苷（cAMP）和钙水平增加发病率和死亡率。左西孟旦是一种新型正性肌力药物，具有ATP依赖性钾通道开放和钙增敏作用。在关于其不增加细胞内钙浓度的作用以及依赖于细胞内可用钙水平的作用的研究中，已表明它具有与目前通过增加钙浓度发挥作用的正性肌力药物不同的有利特性。本研究旨在通过揭示左西孟旦的活性、疗效和安全性的潜在机制，综述关于它的其他重要研究。
