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- 저자 : ( Joana Cochicho ) (검색결과 1 건)
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( Joao Gomes Pereira ),( Joana Cochicho ),( Rui Baptista ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Levosimendan is a calcium sensitiser, acting by increasing the sensitivity of the heart cells to calcium, thus increasing cardiac contractility without a rise in intracellular calcium. Levosimendan exerts its positive inotropic effect 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. Moreover, by opening also the mitochondrial (ATP)-sensitive potassium channels in cardiomyocytes, the drug exerts a cardioprotective effect. Levosimendan is indicated for inotropic support in acutely-decompensated severe congestive heart failure. Having in mind the crescent use of this drug in patients with severe heart failure admitted to the ICU, it is important to assess the security and the different outcomes and cross-reference this information with the various comorbidities found in each patient. Therefore, it is possible to identify in which patients the use of levosimendam is preferred over the other various positive inotropic drugs available in the ICU, in order to establish a valuable treatment guideline.
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