左西孟旦在心脏外科手术的应用

心脏外科手术中体外循环后心功能障碍的病人常需要正性肌力药物的支持.传统的正性肌力药由于存在增加心肌氧耗和致心律失常的危险,临床应用受到一定限制.左西孟旦,一种新型强心剂-钙增敏剂,其强心作用机制是增加心肌收缩蛋白对钙离子的敏感性,并通过激活KATP发挥扩血管和抗缺血效应.现有的临床资料表明左西孟旦在治疗术中高危或合并左心功能不全的心脏手术病人以及帮助病人顺利脱离体外循环方面具有很好的应用前景.

Application of levosimendan in cardiac surgery

Patients suffering from ventricular dysfunction after cardiac surgery with cardiopulmonary bypass (CPB) often require positive inotropic support. The use of conventional inotropic agents is limited in clinic because of their increasing myocardial oxygen consumption and/or proarrhythmia. Levosimendan, a member of new class (calcium sensitizer) of inotropic agents, enhances cardiac contractility via increasing calcium sensitization of contractile proteins, and produces vasodilation and anti-ischemia effect by opening KATP channel. The available clinical evidences show that levosimendan is effective for treatment of cardiac surgical patients with high perioperative risk or compromised left ventricular function, and rescues patients with difficulties in weaning from CPB.