Beneficial effects of levosimendan on cerebral vasospasm induced by subarachnoid haemorrhage: an experimental study.
ABSTRACT The aim of this study was to investigate the ability of levosimendan to prevent cerebral vasospasm in a rabbit model of subarachnoid haemorrhage (SAH).
Eighteen New Zealand white rabbits were allocated into three groups randomly. SAH was induced by injecting autologous blood into the cisterna magna. (Group 1 = control:sham surgery group, Group 2 = SAH alone group, Group 3 = SAH plus levosimendan group). Histopathological examination was performed on day 3 as described. Intravenous levosimendan dose (initially 12 microg kg(-1) infusion, continuously for at least 10 minutes and then continued with a dose of 0.2 microg kg(-1) min(-1)) treatment was started after the induction of SAH. Three days later, the animals were sacrificed.
In pathological investigation; there was statistically significant difference in luminal area and muscular wall thickness of the basilar artery between all groups (p < 0.005). Malondialdehyde level was also found significantly low in the levosimendan group compared with the SAH group.
Intravenous levosimendan treatment was found effective by increasing the pathological luminal area and reducing muscular wall thickness measurements. This is the first study to show that intravenous administration of levosimendan is effective in preventing cerebral vasospasm induced by SAH in rabbits.
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ABSTRACT: Background:The effects of levosimendan(Levo) on injury patterns in the immature brain following cardiopulmonary bypass (CPB) are unknown.Methods:Eighteen 3-4 week-old anesthetised lambs, instrumented with vascular catheters, aortic and right carotid artery flow probes, were allocated to non-CPB, CPB or CPB+Levo groups(each n=6). After 120 mins CPB with 90 mins aortic cross-clamp, CPB animals received dopamine, and CPB+Levo animals both dopamine and Levo, for 4 hrs. All lambs then underwent brain MRI, followed by post-mortem brain perfusion fixation for immunohistochemical studies.Results:In CPB lambs, aortic(P<0.05) and carotid artery(P<0.01) blood flows fell by 29% and 30 % between 2-4 hr after cross clamp removal, but were unchanged in the CPB+levo group. No brain injury was detectable with MRI in either CPB or CPB+Levo lambs. However, on immunohistochemical analysis, white matter astrocyte density of both groups was higher than in non-CPB lambs (P<0.05), while white matter microglial density was higher (P<0.05), but markers of cortical oxidative stress less prevalent in CPB+Levo than CPB lambs.Conclusions:While Levo prevented early post-operative falls in cardiac output and carotid artery blood flow in a lamb model of infant CPB, this was associated with heterogenous neuroglial activation and manifestation of markers of oxidative stress.Pediatric Research (2014); doi:10.1038/pr.2014.51.Pediatric Research 04/2014; · 2.67 Impact Factor
- International journal of cardiology. 08/2014;
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ABSTRACT: Although initial resuscitation from cardiac arrest (CA) has increased over the past years, long term survival rates remain dismal. Epinephrine is the vasopressor of choice in the treatment of CA. However, its efficacy has been questioned, as it has no apparent benefits for long-term survival or favourable neurologic outcome. Levosimendan is an inodilator with cardioprotective and neuroprotective effects. Several studies suggest that it is associated with increased rates of return of spontaneous circulation as well as improved post-resuscitation myocardial function and neurological outcome. The purpose of this article is to review the properties of levosimendan during cardiopulmonary resuscitation (CPR) and also to summarize existing evidence regarding the use of levosimendan in the treatment of CA.European journal of pharmacology. 06/2014;