ArticleJournal of cardiovascular pharmacology2018
Use of Levosimendan in Cardiac Surgery: An Update After the LEVO-CTS, CHEETAH, and LICORN Trials in the Light of Clinical Practice.
Article in Journal of cardiovascular pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Levosimendan vs. Intra-Aortic Balloon Pump in Coronary Artery Bypass Grafting: A Meta-Analysis.Brazilian journal of cardiovascular surgery · 2026Pooled it
- The efficacy and safety of prophylactic use of levosimendan on patients undergoing coronary artery bypass graft: a systematic review and meta-analysis.Journal of anesthesia · 2019Pooled it
- Levosimendan in Cardiogenic Shock: A Review of Mechanisms, Clinical Evidence, and Therapeutic Use.Reviews in cardiovascular medicine · 2026Review
- Article
- [Pro: Levosimendan in Cardiac Surgery].Die Anaesthesiologie · 2024Article
- [Cons: Levosimendan for cardiac surgery].Die Anaesthesiologie · 2024Article
- Predictors of low cardiac output syndrome after combined mitral and tricuspid valve surgery.Frontiers in cardiovascular medicine · 2024Article
- A Comment on the use of Levosimendan for the Management of Right Ventricular Dysfunction in Patients Undergoing Mitral Valve Surgery.Annals of cardiac anaesthesia · 2024Article
- Monitoring of Levosimendan Administration in Patients with Pulmonary Hypertension Undergoing Cardiac Surgery and Effect of Two Different Dosing Schemes on Hemodynamic and Echocardiographic Parameters.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Preoperative Levosimendan therapy reduces postoperative right ventricular failure in patients undergoing left ventricular assist device implantation.Interdisciplinary cardiovascular and thoracic surgery · 2023Article
- The Diagnosis and Treatment of Postoperative Right Heart Failure.Deutsches Arzteblatt international · 2022Review
- The Adenylate Cyclase Activator Forskolin Potentiates the Positive Inotropic Effect of the Phosphodiesterase Inhibitor Milrinone But Not of the Calcium Sensitizer Levosimendan nor of Its Hemodynamically Active Metabolites: An Apparent Conundrum.Journal of cardiovascular pharmacology · 2022Article
- The evaluation of levosimendan in patients with acute myocardial infarction related ventricular septal rupture undergoing cardiac surgery: a prospective observational cohort study with propensity score analysis.BMC anesthesiology · 2022Observational
- Levosimendan in intensive care and emergency medicine: literature update and expert recommendations for optimal efficacy and safety.Journal of anesthesia, analgesia and critical care · 2022Review
- Levosimendan Postconditioning Attenuates Cardiomyocyte Apoptosis after Myocardial Infarction.Journal of healthcare engineering · 2022Article
- Preoperative, Multidisciplinary Clinical Optimization of Patients with Severely Depressed Left Ventricular Ejection Fraction Who Are Undergoing Coronary Artery Bypass Grafting.Cardiology and therapy · 2021Review
- Comprehensive Comparisons among Inotropic Agents on Mortality and Risk of Renal Dysfunction in Patients Who Underwent Cardiac Surgery: A Network Meta-Analysis of Randomized Controlled Trials.Journal of clinical medicine · 2021Article
- [Individualized use of levosimendan in cardiac surgery].Der Anaesthesist · 2021Article
- Levosimendan in Europe and China: An Appraisal of Evidence and Context.European cardiology · 2021Review
- Evidence and Current Use of Levosimendan in the Treatment of Heart Failure: Filling the Gap.Drug design, development and therapy · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Levosimendan is a calcium sensitizer and adenosine triphosphate-dependent potassium channel opener, which exerts sustained hemodynamic, symptomatic, and organ-protective effects. It is registered for the treatment of acute heart failure, and when inotropic support is considered appropriate. In the past 15 years, levosimendan has been widely used in clinical practice and has also been tested in clinical trials to stabilize at-risk patients undergoing cardiac surgery. Recently, 3 randomized, placebo-controlled, multicenter studies (LICORN, CHEETAH, and LEVO-CTS) have been published reporting on the perioperative use of levosimendan in patients with compromised cardiac ventricular function. Taken together, many smaller trials conducted in the past suggested beneficial outcomes with levosimendan in perioperative settings. By contrast, the latest 3 studies were neutral or inconclusive. To understand the reasons for such dissimilarity, a group of experts from Austria, Belgium, Finland, France, Germany, Italy, Switzerland, and Russia, including investigators from the 3 most recent studies, met to discuss the study results in the light of both the previous literature and current clinical practice. Despite the fact that the null hypothesis could not be ruled out in the recent multicenter trials, we conclude that levosimendan can still be viewed as a safe and effective inodilator in cardiac surgery.
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Registered trials
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