On the role of levosimendan in restoring the function of hibernated myocardium in patients with coronary artery disease with reduced cardiac contractility during CABG operations

Purpose of the study: to study the effect of perioperative use of levosimendan on the restoration of viable myocardium in patients with coronary artery disease with a significantly reduced left ventricular ejection fraction during myocardial revascularization. An open, prospective, randomized study was conducted, including 98 patients.The patients were divided into two groups. In group I (n = 55), levosimendan infusion was used perioperatively. Administration of the drug (loading dose of 12 mcg/kg/min for 10 minutes) began after induction of anesthesia and continued infusion at all stages of the operation and in the immediate postoperative period. The total time of drug administration was 24 hours. In group II (n = 43), standard drugs were used to correct the circulatory system. It was found that the inclusion of levosimendan in a comprehensive program of cardioprotection caused a more rapid recovery of hibernated myocardium. This assumption is based on the fact that in patients of group I, the use of levosimendan led to a decrease in the volume of hibernation after surgery, in comparison with the preoperative level, by 42%. At the same time, in group II of patients operated on without the use of the drug, the percentage reduction in the volume of viable myocardium was 13%. In addition, a clear dependence of the state of the pumping function of the heart on the hemodynamic effects of levosimendan was discovered. Thus, in patients of group I, an increase in cardiac index was detected from 2.23±0.49 to 2.96±0.52 l./min./m2 (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }