Myocardial Hemodynamic Effects of Levosimendan
Myocardial Hemodynamic Effects of Levosimendan
This study will test the hypothesis that mechanical efficiency as measured by pressure-volume
 loop assessment should improve during short-term treatment with intravenous levosimendan.

 Levosimendan (SimdaxTM, Abbott Laboratories, Abbott Park, IL) is a calcium sensitizer which
 has been shown to have beneficial hemodynamic effects in patients with decompensated
 congestive heart failure (CHF). Levosimendan is a new calcium sensitizer that binds to
 troponin C. This agent is approved in Europe for treatment of heart failure patients. In the
 United States, this agent is currently under phase III investigation for intravenous
 treatment of patients with acutely decompensated HF who have dyspnea at rest or with minimal
 activity. Levosimendan has been studied in these patients with acute HF and is considered
 experimental in the United States for this population.
Inclusion Criteria:

 -  All patients will have either a sinus or paced atrial rhythm with atrioventricular
 synchrony on electrocardiography

 -  All patients will have a history of heart failure diagnosed clinically with history of
 prior symptoms or signs of heart failure with at least one of the following symptoms
 within the past month: dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea,
 pedal edema

 -  In asymptomatic patients, patients may be enrolled if they have at least one of the
 following clinical signs of heart failure: left ventricular third and/or fourth heart
 sound, jugular venous pressure >7 mmHg, sustained left ventricular impulse, or
 pulmonary congestion on auscultation

 -  all patients will have echocardiographic evidence of left ventricular dysfunction

 Exclusion Criteria:

 -  Under age 18