Wirkt Levosimendan bei der operativen Versorgung des akuten Koronarsyndroms inoprotektiv?

Zusammenfassung

Levosimendan ist ein Kalzium-Sensitiser mit zwei Hauptwirkungen. Zum einen ist Levosimendan durch Kalzium abhängige Bindung an das Troponin C eine positiv inotrope Substanz. Darüber hinaus aktiviert Levosimendan die ATP abhängigen Kalium-Kanäle (K_ATP-Kanäle). Durch die Aktivierung der K_ATP-Kanäle übt Levosimendan in einer Dosierung, die positiv inotrop wirkt, eine Myokardprotektion und auch Vasodilatation aus. Aufgrund dieser Eigenschaften scheint Levosimendan bei Patienten mit akuter myokardialer Ischämie, die gleichzeitig eine positiv inotrope Unterstützung benötigen, sehr vorteilhaft zu sein. Anhand von sechs Fallberichten wird das Konzept der perioperativen Inoprotektion bei akutem Koronarsyndrom vorgestellt.

Abstract

Levosimendan, is a new calcium sensitiser with 2 major effects. First, levosimendan acts as a positive inotropic agent by binding calcium dependently to cardiac troponin C. Second, levosimendan activates adenosine triphosphate-regulated potassium (K_ATP) channels. Thus it has vasodilatory properties and cardioprotective effects at a dose enhancing myocardial contractility. These unique properties of levosimendan might be of great advantage in patients with myocardial ischemia simultaneously requiring inotropic support. The concept of perioperative inoprotection is presented in 6 patients with acute ischemia undergoing emergent cardiac surgery.

Schlüsselwörter

Levosimendan - Kardioprotektion - myokardiale Ischämie - Herzchirurgie

Key words

Levosimendan - cardioprotection - myocardial ischemia - cardiac surgery

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