umu.sePublications
Change search
ReferencesLink to record
Permanent link

Direct link
Effects of Combined Milrinone and Levosimendan Treatment on Systolic and Diastolic Function During Postischemic Myocardial Dysfunction in a Porcine Model
Örebro University, Örebro, Sweden .
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Show others and affiliations
2016 (English)In: Journal of Cardiovascular Pharmacology and Therapeutics, ISSN 1074-2484, E-ISSN 1940-4034Article in journal (Refereed) Epub ahead of print
Abstract [en]

It is not known whether there are positive or negative interactions on ventricular function when a calcium-sensitizing inotrope is added to a phosphodiesterase inhibitor in the clinical setting of acute left ventricular (LV) dysfunction. We hypothesized that when levosimendan is added to milrinone treatment, there will be synergetic inotropic and lusitropic effects. This was tested in an anesthetized porcine postischemic global LV injury model, where ventricular pressures and volumes (conductance volumetry) were measured. A global ischemic injury was induced by repetitive left main stem coronary artery occlusions. Load-independent indices of LV function were assessed before and after ventricular injury, after milrinone treatment, and finally after addition of levosimendan to the milrinone treatment. Nonparametric, within-group comparisons were made. The protocol was completed in 12 pigs, 7 of which received the inotrope treatment and 5 of which served as controls. Milrinone led to positive lusitropic effects seen by improvement in tau after myocardial stunning. The addition of levosimendan to milrinone further increased lusitropic state. The latter effect could however not be attributed solely to levosimendan, since lusitropic state also improved spontaneously in time-matched controls at the same rate during the corresponding period. When levosimendan was added to milrinone infusion, there was no increase in systolic function (preload recruitable stroke work) compared to milrinone treatment alone. We conclude that in this model of postischemic LV dysfunction, there appears to be no clear improvement in systolic or diastolic function after addition of levosimendan to established milrinone treatment but also no negative effects of levosimendan in this context.

Place, publisher, year, edition, pages
Sage Publications, 2016.
Keyword [en]
cardiac pharmacology, cardioactive agents, experimental and clinical heart failure, ischemia-reperfusion injury
National Category
Anesthesiology and Intensive Care Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-116180DOI: 10.1177/1074248416628675PubMedID: 26837238ISBN: 1940-4034 (Electronic) 1074-2484 (Linking)OAI: oai:DiVA.org:umu-116180DiVA: diva2:901781
Available from: 2016-02-09 Created: 2016-02-09 Last updated: 2016-02-12Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Häggmark, SörenSvenmarker, StaffanJohansson, GöranHaney, Michael
By organisation
Anaesthesiology
In the same journal
Journal of Cardiovascular Pharmacology and Therapeutics
Anesthesiology and Intensive CareCardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 31 hits
ReferencesLink to record
Permanent link

Direct link