• L Tritapepe, V De Santis, D Vitale, M Santulli, A Morelli, I Nofroni, P E Puddu, M Singer, and P Pietropaoli.
• Department of Anesthesiology and Intensive Care, University of Rome La Sapienza, Rome, Italy.
• Br J Anaesth. 2006 Jun 1;96(6):694-700.

BackgroundThe calcium sensitizer levosimendan protects against myocardial ischaemia and reperfusion injury in animal models.MethodsThe present pilot study investigated whether a short infusion before coronary artery bypass grafting (CABG) would protect the myocardium and improve postoperative haemodynamics. Twenty-four patients with stable angina undergoing elective CABG surgery were randomized to receive either placebo or levosimendan (24 microg kg(-1)) infused i.v. over a 10 min period just before placing the patient on cardiopulmonary bypass.ResultsPerioperative haemodynamic variables, concentrations of cardiac troponin I over the 48 h postoperative period, and clinical outcomes were assessed. There were no adverse effects related to levosimendan. Compared with control patients, levosimendan-treated patients had lower postoperative troponin I concentrations (P<0.05) and a higher cardiac index (P<0.05).ConclusionPatients receiving a short infusion of levosimendan before CABG showed evidence of less myocardial damage, suggestive of a preconditioning effect. Larger outcome studies are thus indicated to confirm benefit.

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