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Anesth Analg 2006;103:1094-1098
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000244326.38206.a0

CARDIOVASCULAR ANESTHESIA

The Vasodilatory Effects of Levosimendan on the Human Internal Mammary Artery

Félix R. Montes, MD*, Darío Echeverri, MD{dagger}, Lorena Buitrago, MB{ddagger}, Isabel Ramírez, IE§, Juan C. Giraldo, MD*, Javier D. Maldonado, MD||, and Juan P. Umaña, MD||

From the Departments of *Anesthesiology, {dagger}Cardiology, ||Cardiovascular Surgery, {ddagger}Laboratory of Vascular Function, Fundación CardioInfantil, Instituto de Cardiología; and §Facultad de Ingeniería Industrial, Universidad de Los Andes, Bogota, Colombia, South America.

BACKGROUND: Levosimendan, an inotropic drug that enhances myocardial contractility through myofilment calcium sensitazion, induces peripheral vasodilation via opening ATP-dependent K+ channels. It is unknown whether this drug can be used for the treatment of perioperative vasospasm of arterial conduits used for coronary artery bypass grafting.

METHODS: We investigated the effects of levosimendan on human internal mammary artery (IMA) specimens taken from patients undergoing coronary artery bypass surgery. The rings were carefully prepared and placed between two wire hooks in organ bath chambers and then constricted submaximally with norepinephrine and thromboxane A2 analog (U46619). Nitroglycerin, milrinone, and levosimendan were separately added in a cumulative fashion and concentration response curves for relaxation were constructed. In parallel experiments, the response to levosimendan was evaluated on rings with and without functional endothelium. Levosimendan prevention of norepinephrine-induced contraction was also estimated.

RESULTS: Nitroglycerin, milrinone, and levosimendan completely reversed the contraction of the IMA segments induced by U46619 and norepinephrine. Levosimendan produced a potent, concentration-dependent preventive effect on the norepinephrine-induced contraction of IMA. The responses to levosimendan were similar in preparations with or without endothelium.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.