Levosimendan ( INN ) (pronounced /?li?vo?sa??m?nd?n/ ) is a calcium sensitiser used in the management of acutely decompensated congestive heart failure . It is marketed under the trade name Simdax ( Abbott ). more

Levosimendan ( INN ) (pronounced /?li?vo?sa??m?nd?n/ ) is a calcium sensitiser used in the management of acutely decompensated congestive heart failure . It is marketed under the trade name Simdax ( Abbott ).

Levosimendan is a calcium sensitiser ? it increases the sensitivity of the heart to calcium, thus increasing cardiac contractility without a rise in intracellular calcium. Levosimendan exerts its positive inotropic effect by increasing calcium sensitivity of myocytes 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. less