An emerging role for calcium sensitisation in the treatment of heart failure

Author: Erhardt Leif  

Publisher: Informa Healthcare

ISSN: 1354-3784

Source: Expert Opinion on Investigational Drugs, Vol.14, Iss.6, 2005-06, pp. : 659-670

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Abstract

Heart failure occurs in 2 – 3% of the adult population in the developed world. With decompensation of cardiac function, haemodynamic stability can be achieved by using intravenous vasodilators, diuretics and inotropes. Unlike traditional inotropes, Ca2+ sensitisers enhance cardiac function without significantly increasing cardiac oxygen consumption, promoting arrhythmia or impairing lusitropy. The most promising drug in this new class is levosimendan, which has a unique dual mechanism; it enhances cardiac output through a Ca2+-dependent stabilisation of cardiac myofilaments and exhibits vasodilatory effects by opening ATP-dependent K+ channels. Clinical trials have demonstrated the beneficial haemodynamic effects of levosimendan, and prospective trials are currently underway to confirm its potential benefits on long-term prognosis. Updated guidelines from the European Society of Cardiology advise on how to incorporate levosimendan into care for patients who have acute heart failure.