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Anästhesiol Intensivmed Notfallmed Schmerzther 2003; 38(9): 577-582
DOI: 10.1055/s-2003-41861
Der besondere Beitrag
© Georg Thieme Verlag Stuttgart · New York

Wirkt Levosimendan bei der operativen Versorgung des akuten Koronarsyndroms inoprotektiv?

Is Levosimendan an Inoprotective Drug in Patients with Acute Coronary Syndrome Undergoing Surgical Revascularization?A.  Lehmann1 , J.  Boldt1 , J.  Lang1 , F.  Isgro2 , M.  Blome2
  • 1Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum der Stadt Ludwigshafen
  • 2Klinik für Herzchirurgie, Klinikum der Stadt Ludwigshafen
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Publication History

Publication Date:
16 September 2003 (online)

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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 (KATP-Kanäle). Durch die Aktivierung der KATP-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 (KATP) 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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Dr. Andreas Lehmann

Klinik für Anästhesiologie und Operative Intensivmedizin Klinikum der Stadt Ludwigshafen

Bremserstraße 79

67063 Ludwigshafen

Email: Dr. A.Lehmann@web.de