A review of levosimendan in the treatment of heart failure

Heart failure is a relatively important public health problem due to its increasing incidence, poor prognosis, and frequent need of re-hospitalization. Intravenous positive inotropic agents play an important role in treating acute decompensation of patients with heart failure due to left ventricular systolic dysfunction. Although frequently used, the inotropic agents β-adrenergic agonists and phosphodiesterase inhibitors seem effective for improving symptoms in the short term; it has been shown that they increase morbidity and mortality by elevating intracellular cyclic adenosine monophosphate (cAMP) and calcium levels. Levosimendan is a new positive inotropic agent having ATP-dependent potassium-channel-opening and calcium-sensitizing effects. In studies on its effects without increasing intracellular calcium concentrations and on its effects that depend on available intracellular calcium levels, it has been shown to have favorable characteristics different from those of current inotropic agents, which exert their effects by increasing calcium concentrations. This study aims to review other important studies about levosimendan by revealing the underlying mechanisms of its activity, efficiency, and safety

Occult cardiac dysfunction in patients with obstructive sleep apnea syndrome revealed by tissue Doppler imaging

Obstructive sleep apnea syndrome has been linked to cardiovascular complications. The diagnosis of effects of sleep apnea on heart may be difficult before apparent examination findings. The aim of the present study was to evaluate changes of myocardial contractile properties in patients affected by sleep apnea showing tissue Doppler imaging, in the face of quite normal myocardial contractility on standard echocardiography. Shortly, tissue Doppler imaging may represent an early stage of myocardial abnormality despite a preserved global function. (C) 2006 Elsevier Ireland Ltd. All rights reserved

Do calcium sensitizers affect right ventricular functions in patients with chronic heart failure?

Calcium sensitizers also improve cardiac function by increasing the contraction of the myocardium without significantly increasing intracellular calcium levels. Although right ventricular function is an important role for better cardiac global function, there is no study about effects of levosimendan on right ventricular function measured by tissue Doppler imaging. The aim of the present study was to evaluate changes of myocardial properties in patients with idiopathic dilated cardiomyopathy using tissue Doppler imaging after levosimendan infusion. This tissue Doppler study shows that levosimendan also affects myocardial especially systolic waves of right ventricle and those of left ventricle. (C) 2006 Elsevier Ireland Ltd. All rights reserved

Aortic elastic properties in athletes using anabolic-androgenic steroids

The use of anabolic-androgenic steroids (AAS) has been linked to acute cardiovascular events in athletes. The purpose of the present study was to investigate the aortic elastic properties in athletes who had been self-administering AAS compared with a group of athletes not using these drugs. Fourteen male bodybuilders using AAS and 27 male wrestlers (non-users) volunteered to the study. All subjects were placed in a mild recumbent position and the ascending aorta was recorded in the two-dimensional guided M-mode tracings. Although the aortic distensibility was found to be reduced in user athletes (2.1 +/- 1.1 vs. 3.8 +/- 1.4 cm(2) dyn(-1) 10(-6), p = 0.01; 9.3 +/- 3.7 vs. 5.9 +/- 2.5, p = 0.003, respectively). The results of this study indicate that aortic stiffness is increasing in athletes using AAS. (c) 2005 Elsevier Ireland Ltd. All rights reserved

Infective endocarditis in Turkey: aetiology, clinical features, and analysis of risk factors for mortality in 325 cases

Objective: In order to define the current characteristics of infective endocarditis (LE) in Turkey, we evaluated LE cases over a 14-year period in a tertiary referral hospital

Pregnancy-associated plasma protein A (PAPP-A) and severity of coronary atherosclerosis assessed by angiographic Gensini score

Background: Pregnancy-associated plasma protein A (PAPP-A) is a potentially proatherosclerotic metalloproteinase, which has been shown to be abundantly expressed in ruptured unstable plaques. However, changes of the PAPP-A blood levels in patients with coronary artery disease (CAD) according to the Gensini score is unknown in Turkish population