Compounds > simendan
Page last updated: 2024-12-06

simendan

Description

Simendan: A hydrazone and pyridazine derivative; the levo-form is a phosphodiesterase III inhibitor, calcium-sensitizing agent, and inotropic agent that is used in the treatment of HEART FAILURE. [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

Cross-References

ID SourceID
PubMed CID60867
CHEMBL ID313136
SCHEMBL ID80460
MeSH IDM0206272

Synonyms (29)

Synonym
CHEMBL313136
131741-08-7
simendan
mesoxalonitrile (+-)-(p-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)phenyl)hydrazone
propanedinitrile, ((4-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)phenyl)hydrazono)-
simendan [inn]
2-[[4-(4-methyl-6-oxo-4,5-dihydro-1h-pyridazin-3-yl)phenyl]hydrazinylidene]propanedinitrile
FT-0657758
349552krhk ,
unii-349552krhk
FT-0631139
AKOS015907719
SCHEMBL80460
propanedinitrile, 2-(2-(4-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)phenyl)hydrazinylidene)-
157968-98-4
2-(2-(4-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)phenyl)hydrazinylidene)propanedinitrile
mesoxalonitrile (+/-)-(p-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)phenyl)hydrazone
HMS3656A21
DB12286
{[4-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)phenyl]hydrazono} propanedinitrile
simsndan;or-1259
BCP09589
DTXSID20861357
AMY18162
SB17415
HMS3744M15
propanedinitrile, 2-[2-[4-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)phenyl]hydrazinylidene]-
Q27256351
bdbm50469701

Research Excerpts

Overview

Levosimendan is a calcium sensitizer used for managing heart failure (HF) because of its inotropic and vasodilatory effects. It increases calcium sensitivity to cardiac myocytes, which results in improved cardiac contractility that last for approximately 7 days.

ExcerptReferenceRelevance
"Levosimendan is a calcium sensitizer used for managing heart failure (HF) because of its inotropic and vasodilatory effects. "( Effect of levosimendan combined with recombinant human brain natriuretic peptide on diuretic resistance.
Jun, M; Lan, L; Libiya, Z; Shubin, J; Xiangli, S, 2021)		1.54
"Levosimendan (LEVO) is a positive inotropic drug which could increase myocardial contractility and reduce the mortality rate in cardiac surgical patients. "( Levosimendan administration is not associated with increased risk of bleeding and blood transfusion requirement in patients undergoing off-pump coronary artery bypass grafting: a retrospective study from single center.
Fu, RQ; He, LX; Lin, Y; Tan, JC; Wang, LH; Wang, XH; Yao, YT, 2023)		2.03
"Levosimendan (LEV) is a calcium sensitizer with a pleiotropic effect on multiple organs."( The Effect of Levosimendan on Phosphine-Induced Nephrotoxicity: Biochemical and Histopathological Assessment.
Abdollahi, M; Armandeh, M; Baeeri, M; Bameri, B; Farhadi, R; Haghi-Aminjan, H; Khalid, M; Rahimifard, M, 2022)		1.54
"Levosimendan is a safe and effective short-term therapy in AHF and offers comparable long-term survival to COSI in patients who require BTD or BTT therapy."( Levosimendan and Continuous Outpatient Support With Inotropes in Patients With Advanced Heart Failure: A Single-Centre Descriptive Study.
Bergin, P; Cieslik, L; Dagan, M; Hare, JL; Kaye, DM; Lankaputhra, M; Leet, A; Patel, HC; Taylor, AJ; Warner, V; Yeung, T, 2022)		1.76
"Levosimendan is a potent inotropic drug that increases calcium sensitivity to cardiac myocytes, which results in improved cardiac contractility that last for approximately 7 days."( Effect of perioperative levosimendan administration on postoperative N-terminal pro-B-type natriuretic peptide concentration in patients with increased cardiovascular risk factors undergoing non-cardiac surgery: protocol for the double-blind, randomised,
Adamowitsch, N; Berger, C; Clement, T; Fleischmann, E; Fraunschiel, M; Graf, A; Horvath, K; Kabon, B; Kuhrn, M; Reiterer, C; Taschner, A; Treskatsch, S, 2022)		1.5
"Levosimendan is a novel drug often used to treat heart failure. "( Effects of Levosimendan Preconditioning on Left Ventricular Remodeling after Myocardial Reperfusion in Acute Myocardial Infarction Patients Receiving Percutaneous Coronary Intervention.
Yu, S; Zhang, J, 2022)		1.63
"Levosimendan is an inotropic and vasodilator drug used to treat heart failure."( A New Approach in the Treatment of Traumatic Brain Injury: The Effects of Levosimendan on Necrosis, Apoptosis, and Oxidative Stress.
Akyol, ME; Aycan, A; Ergur, B; Gonullu, E; Kume, T; Kuyumcu, F; Oksuz, E; Tas, A, 2022)		1.43
"Levosimendan (LVSMD) is a calcium-sensitizer inotropic and vasodilator agent whose use might have a beneficial effect on the weaning of venoarterial extracorporeal membrane oxygenation (VA-ECMO). "( Population Pharmacokinetics of Levosimendan and its Metabolites in Critically Ill Neonates and Children Supported or Not by Extracorporeal Membrane Oxygenation.
Berthomieu, L; Bourgoin, P; Chenouard, A; Davril, E; Duflot, T; Joram, N; Lamoureux, F; Lecomte, J; Oualha, M; Pereira, T, 2023)		1.75
"Levosimendan is an effective inotropic agent used to maintain cardiac output similar to classic cardiotonic like dobutamine/dopamine."( Preoperative Levosimendan Administration in Heart Transplant Patients with Severe Hepatic and Renal Impairment: A Retrospective Study.
Dong, N; Guo, Q; Lan, H; Li, C; Shi, J; Wang, G; Xiong, T; Zhang, J; Zheng, Q, 2023)		1.73
"Levosimendan is a calcium sensitizer and inodilator, and it is known to improve ventricular function, but its use in newborns is limited."( Use of levosimendan in hemodynamic management of heart failure in two neonates with intracranial arteriovenous shunts: a case series.
Capolupo, I; Columbo, C; De Rose, DU; Di Chiara, L; Dotta, A; Gandolfo, C; Giliberti, P; Landolfo, F; Martini, L; Pugnaloni, F; Ronchetti, MP; Santisi, A; Toscano, A, 2023)		1.78
"Levosimendan is a vasodilating and inotropic agent used in patients with acute heart failure and has resulted in decreased morbidity and mortality in these patients."( Meta-Analysis of the Efficacy of Levosimendan in the Treatment of Severe Sepsis Complicated with Septic Cardiomyopathy.
Guan, Q; Huang, D; Li, A; Li, B; Qin, J; Zhang, C; Zhang, X, 2023)		1.66
"Levosimendan is a calcium sensitizer associated with an influx of calcium ions and activation of ATP-dependent potassium channels that increases myocardial contractility contractions, enhances vasodilation and improves oxygen supply to the cells and tissues."( Meta-Analysis of the Efficacy of Levosimendan in the Treatment of Severe Sepsis Complicated with Septic Cardiomyopathy.
Guan, Q; Huang, D; Li, A; Li, B; Qin, J; Zhang, C; Zhang, X, 2023)		1.74
"Levosimendan is a calcium sensitizer and ATP-dependent potassium channel opener that was developed as an inodilating drug for the treatment of acute heart failure and cardiogenic shock."( Rationale, experimental data, and emerging clinical evidence on early and preventive use of levosimendan in patients with ventricular dysfunction.
Agostoni, P; Cosentino, N; Fracassi, F; Marenzi, G; Niccoli, G; Rebuzzi, A, 2020)		1.26
"Levosimendan is a calcium sensitizer that promotes myocyte contractility through its calcium-dependent interaction with cardiac troponin C. "( Potential of the Cardiovascular Drug Levosimendan in the Management of Amyotrophic Lateral Sclerosis: An Overview of a Working Hypothesis.
Al-Chalabi, A; Heunks, LMA; Papp, Z; Pollesello, P, 2019)		1.34
"Levosimendan is an inotropic agent for the treatment of low cardiac output syndrome that seems to have a protective effect on renal function."( Preservation of renal function in cardiac surgery patients with low cardiac output syndrome: levosimendan vs beta agonists.
Barrera Serrano, R; Bellido Estevez, I; Cruz Mañas, J; Escalona Belmonte, JJ; Gomez Luque, A; Guerrero Orriach, JL; Hernandez Rodriguez, P; Malo Manso, A; Navarro Arce, I; Raigón Ponferrada, A; Ramirez Aliaga, M; Ramirez Fernandez, A; Rubio Navarro, M; Toledo Medina, CS, 2019)		1.21
"Levosimendan is a potent non-adrenergic inodilator agent. "( Levosimendan and systemic vascular resistance in cardiac surgery patients: a systematic review and meta-analysis.
Carrel, T; Eberle, B; Erdoes, G; Friess, JO; Guensch, D; Heinisch, PP; Lenz, A; Terbeck, S, 2019)		1.63
"Levosimendan is a calcium sensitizer and phosphodiesterase inhibitor that has potent antioxidant and anti-inflammatory activities."( Levosimendan Prevents Memory Impairment Induced by Diabetes in Rats: Role of Oxidative Stress.
Alzoubi, KH; Baydoun, S; Khabour, OF; Rababa'h, AM, 2019)		1.63
"Levosimendan is a positive inotropic agent characterized by vasodilatory properties, which is used for the treatment of acute decompensated heart failure or in patients needing inotropic treatment, including cardiogenic shock, septic shock, pulmonary hypertension and right ventricular dysfunction, needed for hemodynamic support in patients with diuretic resistance, and weaning either from ventilator or from extracorporeal membrane oxygenation."( Levosimendan to facilitate weaning from cardiorespiratory support in critically ill patients: current evidence and future directions.
Affronti, A; Bellani, G; Feri, M; Guarracino, F; Marini, M; Quacquarelli, A; Sangalli, F; Vitale, D; Volpi, F, 2020)		1.6
"Levosimendan is a new inodilator which involves 3 main mechanisms: increases the calcium sensitivity of cardiomyocytes, acts as a vasodilator due to the opening of potassium channels, and has a cardioprotective effect. "( Levosimendan in the treatment of patients with acute cardiac conditions: an expert opinion of the Association of Intensive Cardiac Care of the Polish Cardiac Society.
Bugajski, J; Deja, M; Depukat, R; Gierlotka, M; Gruchała, M; Grześk, G; Kasprzak, JD; Kubica, J; Kucewicz-Czech, E; Leszek, P; Płonka, J; Sobkowicz, B; Stępińska, J; Straburzyńska-Migaj, E; Tycińska, A; Wilk, K; Zawiślak, B; Zymliński, R, 2020)		1.67
"Levosimendan (LEVO), is an inotropic agent which has been shown to be associated with better myocardial performance, and higher survival rate in cardiac surgical patients. "( The effect of levosimendan on postoperative bleeding and blood transfusion in cardiac surgical patients: a PRISMA-compliant systematic review and meta-analysis.
He, LX; Yao, YT; Zhao, YY, 2021)		1.51
"Levosimendan is an effective calcium sensitizer with complementary mechanisms of action: calcium sensitization and opening of adenosine triphosphate-dependent potassium channels, both on the sarcolemma of the smooth muscle cells in the vasculature and on the mitochondria of cardiomyocytes. "( Pre-bypass levosimendan in ventricular dysfunction-effect on right ventricle.
Ahlawat, V; Kumar, D; Kundu, A; Prakash, A; Yadav, A; Yadava, OP, 2021)		1.53
"Levosimendan is a novel long acting effect inodilator used in cardiogenic shock and terminal heart failure decompensation."( Levosimendan in venoarterial ECMO weaning. Rational and design of a randomized double blind multicentre trial.
Abou-Arab, O; Besnier, E; Bouhemad, B; Cransac, A; Ellouze, O; Fischer, MO; Guinot, PG; Ksiazek, E; Mertes, PM; Moussa, M; Radhouani, M; Soudry Faure, A, 2021)		1.66
"Levosimendan is a calcium sensitizer and opens adenosine triphosphate-dependent potassium channels. "( [Levosimendan - a 20-Year Experience].
Häberle, HA, 2021)		1.69
"Levosimendan is a distinctive inodilator combing calcium sensitization, phosphodiesterase inhibition and vasodilating properties through the opening of adenosine triphosphate-dependent potassium channels. "( Evidence and Current Use of Levosimendan in the Treatment of Heart Failure: Filling the Gap.
Conti, N; Diemberger, I; Gatti, M; Potena, L; Raschi, E, 2021)		1.46
"Levosimendan is an inotropic agent that has been shown in small studies to prevent or treat the low cardiac output syndrome after cardiac surgery."( Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery.
Alexander, JH; Anstrom, KJ; Argenziano, M; Bozinovski, J; Duncan, A; Fremes, S; Goodman, SG; Harrington, RA; Harrison, RW; Hay, D; Heringlake, M; Jankowich, R; Kalavrouziotis, D; Leimberger, JD; Levy, JH; Luber, J; Marcel, R; Mehta, RH; Meza, J; Murphy, E; Nagpal, D; Park, S; Soltesz, EG; Toller, W; van Diepen, S; Wang, A, 2017)		1.57
"Levosimendan appears to be a promising drug to reduce mortality and worsening HF in patients with HF/CS-ACS. "( Effects of Levosimendan on Patients with Heart Failure Complicating Acute Coronary Syndrome: A Meta-Analysis of Randomized Controlled Trials.
Shang, G; Shang, Y; Song, D; Tang, M; Ti, Y; Wang, Z; Yang, X; Zhang, W; Zhang, Y; Zhong, M, 2017)		1.37
"Levosimendan is a cardiac inotropic drug and vasodilator."( Efficacy and safety of levosimendan in patients with acute right heart failure: A meta-analysis.
Hao, Y; Huang, S; Jia, L; Li, X; Ma, Y; Mao, Y; Qiu, J; Wang, M, 2017)		1.23
"Levosimendan is a calcium sensitizer and adenosine triphosphate-dependent potassium channel opener, which exerts sustained hemodynamic, symptomatic, and organ-protective effects. "( Use of Levosimendan in Cardiac Surgery: An Update After the LEVO-CTS, CHEETAH, and LICORN Trials in the Light of Clinical Practice.
Bettex, D; Bouchez, S; Cholley, B; Guarracino, F; Heringlake, M; Kivikko, M; Lomivorotov, VV; Pollesello, P; Rajek, A, 2018)		1.43
"Levosimendan is a cardiac inotropic and vasodilator agent that has pleotropic effects including antioxidant, anti-inflammatory, and smooth muscle vasodilatory actions."( Levosimendan enhances memory through antioxidant effect in rat model: behavioral and molecular study.
Alzoubi, KH; Atmeh, A; Rababa'h, AM, 2018)		1.52
"Levosimendan is a calcium sensitizer drug causing increased contractility in the myocardium and vasodilation in the vascular system. "( Levosimendan for Perioperative Cardioprotection: Myth or Reality?
Incalzi, RA; Massini, C; Migale, M; Santillo, E, 2018)		1.6
"Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery."( Perioperative Use of Levosimendan Improves Clinical Outcomes in Patients After Cardiac Surgery: A Systematic Review and Meta-Analysis.
Huo, JH; Luo, X; Qiang, H; Wang, ZQ, 2018)		1.27
"Levosimendan is a calcium sensitiser and adenosine triphosphate (ATP)-sensitive potassium channel (I"( [Perioperative use of levosimendan in cardiac surgery. Hungarian recommendation].
Babik, B; Bertalan, A; Bogáts, G; Csomós, Á; Gombocz, K; Hartyánszky, I; Hejjel, L; Koszta, G; Molnár, A; Németh, E; Nyolczas, N; Paulovich, E; Prodán, Z; Sápi, E; Sax, B; Székely, L; Szerafin, T; Szolnoky, J; Szudi, L; Zima, E, 2018)		1.26
"Levosimendan is a new inotropic drug that causes calcium sensitization of troponin C, thus increasing contraction force of myofilaments."( Use of levosimendan in the treatment of cerebral vascular vasospasm: a case study.
Goraj, R; Jalali, R; Nosek, K; Onichimowski, D; Pawlos, A; Tuyakov, B; Wińska, A, 2018)		1.35
"Levosimendan is a calcium sensitizer that is used as positive inotropic drug in acute decompensated heart failure. "( Ranolazine Prevents Levosimendan-Induced Atrial Fibrillation.
Dechering, DG; Eckardt, L; Ellermann, C; Fehr, M; Frommeyer, G; Kochhäuser, S; Kohnke, A; Reinke, F, 2018)		1.35
"Levosimendan is an inotropic agent that has been shown in small studies to treat low cardiac output syndrome in cardiac surgery. "( Levosimendan in patients with low cardiac output syndrome undergoing cardiac surgery: A systematic review and meta-analysis.
Chen, L; He, Y; Qing, X; Zhang, Y; Zhu, J, 2019)		1.63
"Levosimendan is a first-in-class calcium sensitizer and potassium channel opener indicated for the management of acute HF."( Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period.
Allipour Birgani, S; Altenberger, J; Comín-Colet, J; Delgado, JF; Fedele, F; García-Gonzáles, MJ; Gustafsson, F; Masip, J; Papp, Z; Pölzl, G; Störk, S; Ulmer, H; Vrtovec, B; Wikström, G, 2019)		1.35
"Levosimendan is a cardiac inotropic and vasodilator agent that has been reported to have anti-oxidative, anti-inflammatory, and smooth muscle vasodilatory properties. "( Cardioprotective effect of levosimendan against homocysteine-induced mitochondrial stress and apoptotic cell death in H9C2.
Aminzadeh, A; Mehrzadi, S, 2018)		1.33
"Levosimendan is an inodilator that promotes cardiac contractility primarily through calcium sensitization of cardiac troponin C and vasodilatation via opening of adenosine triphosphate-sensitive potassium (KATP) channels in vascular smooth muscle cells; the drug also exerts organ-protective effects through a similar effect on mitochondrial KATP channels. "( Use of Levosimendan in Intensive Care Unit Settings: An Opinion Paper.
Bouchez, S; Girardis, M; Guarracino, F; Herpain, A; Knotzer, J; Levy, B; Liebregts, T; Pollesello, P; Ricksten, SE; Riha, H; Rudiger, A; Sangalli, F, 2019)		1.46
"Levosimendan is a positive inotropic and a vasodilator agent with pleotropic characteristics that include antioxidation, anti-inflammation and smooth muscle vasodilation."( Assessment of Genotoxicity of Levosimendan in Human Cultured Lymphocytes.
Ababneh, M; Al-Momani, D; Alzoubi, KH; Khabour, OF; Rababa'h, AM, 2019)		1.35
"Levosimendan is a novel drug for treatment of sepsis-induced myocardial dysfunction."( Levosimendan as a new force in the treatment of sepsis-induced cardiomyopathy: mechanism and clinical application.
Chen, Z; Sun, Y; Yang, F; Zhao, LN, 2019)		1.55
"Simendan is a calcium sensitizer that enhances myocardial contractility but does not affect ventricular diastole. "( The efficacy of simendan in the treatment of acute heart failure and its impact on NT-proBNP.
Li, J; Li, Y; Wang, XY; Yang, F; Yang, J; Yang, ZY; Yuan, P, 2019)		2.3
"Levosimendan is a new molecule with inotropic and vasodilator effect and is widely used for acute decompensated heart failure."( Rapid recovery from acute myocarditis under levosimendan treatment: report of two cases.
Alici, H; Cakici, M; Davutoglu, V; Ercan, S; Kus, E; Sari, I, 2013)		1.13
"Levosimendan is a novel calcium sensitizer that is an established treatment for congestive heart failure. "( Functional effects of levosimendan in rat basilar arteries in vitro.
Guresir, E; Konczalla, J; Mrosek, J; Platz, J; Schuss, P; Seifert, V; Vatter, H; Wanderer, S, 2013)		1.25
"Levosimendan (LS) is a novel inodilator for the treatment of severe congestive heart failure (CHF). "( Intermittent levosimendan treatment in patients with severe congestive heart failure.
Kivikko, M; Kurttila, M; Laitinen, T; Magga, J; Miettinen, K; Parviainen, I; Peuhkurinen, K; Punnonen, K; Timonen, K; Timonen, P; Tuomainen, PO; Uusaro, A; Vanninen, E; Vuolteenaho, O, 2013)		1.29
"Levosimendan is an inotropic agent with an original mechanism of action."( Pharmacology of levosimendan: inotropic, vasodilatory and cardioprotective effects.
Despas, F; Lebrin, M; Pathak, A; Senard, JM; Vaccaro, A, 2013)		1.19
"Levosimendan is a calcium sensitizer and potassium channel opener used in the treatment of acute heart failure."( Renal effects of levosimendan: a consensus report.
Édes, I; Fedele, F; Grossini, E; Harjola, VP; Hasslacher, J; Kivikko, M; le Noble, J; Mebazaa, A; Morelli, A; Oldner, A; Oulego Erroz, I; Parissis, JT; Parkhomenko, A; Poelzl, G; Pollesello, P; Rehberg, S; Ricksten, SE; Rodríguez Fernández, LM; Salmenperä, M; Silva Cardoso, JC; Singer, M; Treskatsch, S; Vrtovec, B; Wikström, G; Yilmaz, MB, 2013)		1.19
"Levosimendan is a new positive inotropic drug, which induces preconditioning-like adaptive mechanisms due to opening of mitochondrial KATP channels."( Levosimendan: a cardiovascular drug to prevent liver ischemia-reperfusion injury?
Balla, Z; Fulop, A; Garbaisz, D; Harsanyi, L; Hegedus, V; Lotz, G; Onody, P; Rakonczay, Z; Rosero, O; Stangl, R; Szijarto, A; Turoczi, Z, 2013)		1.43
"Levosimendan is a noncatecholamine inotrope that does not increase oxygen consumption, utilized for the treatment for acute heart failure with left ventricular (LV) systolic dysfunction. "( Safety and feasibility of levosimendan administration in takotsubo cardiomyopathy: a case series.
Brunetti, ND; Carpagnano, G; Di Biase, L; Di Biase, M; Ferraretti, A; Ienco, V; Ieva, R; Lodispoto, M; Santoro, F, 2013)		1.24
"Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. "( Perioperative levosimendan therapy is associated with a lower incidence of acute kidney injury after cardiac surgery: a meta-analysis.
Chi, YF; Hou, WM; Niu, ZZ; Sun, WY; Wu, SM, 2014)		1.29
"Levosimendan is a calcium sensitizer with inotropic and vasodilatory effects used in the treatment of severe heart failure."( Levosimendan may improve weaning outcomes in venoarterial ECMO patients.
Affronti, A; Carino, D; di Bella, I; Ragni, T, )		1.17
"Levosimendan is a positive inotropic agent improving cardiac contractility without increasing myocardial oxygen consumption in HF."( Impact of levosimendan on right ventricular functions by using novel tissue Doppler derived indices in patients with ischaemic left ventricular failure.
Alibaz-Oner, F; Erguney, M; Gurbuz, OZ; Oner, E; Yurdakul, S, 2013)		1.23
"Levosimendan (LS) is a novel inodilator that improves cardiac performance, central hemodynamics, and symptoms of patients with decompensated chronic heart failure. "( Comparison of single-dose and repeated levosimendan infusion in patients with acute exacerbation of advanced heart failure.
Acarturk, E; Bacaksiz, A; Bozkurt, A; Demir, M; Eker, RA; Kanadasi, M; Sahin, DY; Tasal, A; Vatankulu, MA, 2014)		1.22
"Levosimendan is a calcium sensitizer drug which has been used in cardiac surgery for the prevention of postoperative low cardiac output syndrome (LCOS) and in difficult weaning from cardiopulmonary bypass (CPB). "( Study of levosimendan during off-pump coronary artery bypass grafting in patients with LV dysfunction: a double-blind randomized study.
Brahmbhatt, A; Malhotra, A; Patel, J; Rathod, B; Shah, B; Shah, R; Sharma, P; Shastri, N, )		1.06
"Levosimendan is an inotropic drug with organ-protective properties due to its activation of mitochondrial K(ATP) channels. "( Influence of levosimendan on organ dysfunction in patients with severely reduced left ventricular function undergoing cardiac surgery.
Beutlhauser, T; Erb, J; Feldheiser, A; Grubitzsch, H; Schuster, B; Spies, C; Treskatsch, S, 2014)		1.3
"Levosimendan is a calcium-sensitizing agent shown to prevent myocardical contractile depression in various heart diseases. "( Improved myocardial function with supplement of levosimendan to Celsior solution.
Chen, YY; Shen, YL; Wang, LL; Zhang, LN; Zheng, MZ; Zhou, HY, 2014)		1.21
"Levosimendan is a new calcium sensitizing drug with vasodilatory and inotropic properties, which is used for the treatment of postoperative low cardiac output syndrome and difficult weaning from cardiopulmonary bypass."( Preoperative levosimendan in ischemic mitral valve repair.
Bishnoi, A; Gandhi, H; Gandhi, S; Garg, P; Malhotra, A; Sharma, P, 2014)		1.3
"Levosimendan is an inodilator with cardioprotective and neuroprotective effects."( The role of Levosimendan in cardiopulmonary resuscitation.
Aroni, F; Stefaniotou, A; Varvarousi, G; Varvaroussis, D; Xanthos, T, 2014)		1.23
"Levosimendan is a promising therapy for prevention of IRI."( Molecular mechanisms contributing to the protective effect of levosimendan in liver ischemia-reperfusion injury.
Abdel-Gaber, SA; Abdelrahman, AM; Amin, EF; Ibrahim, MA; Ibrahim, SA; Mohammed, RK, 2014)		1.12
"Levosimendan is a positive inotropic drug for the treatment of acute decompensated heart failure (HF). "( Levosimendan exerts anti-inflammatory effects on cardiac myocytes and endothelial cells in vitro.
Aliabadi, A; Buchberger, E; de Martin, R; Demyanets, S; Gröger, M; Hofer-Warbinek, R; Huber, K; Kastl, SP; Kaun, C; Krychtiuk, KA; Maurer, G; Pisoni, J; Rauscher, S; Speidl, WS; Watzke, L; Wojta, J; Zuckermann, A, 2015)		1.53
"Levosimendan is a calcium-sensitizing agent that improves cardiac function, hemodynamic performance, and survival in critically ill adult patient. "( A systematic review on levosimendan in paediatric patients.
Azzolini, ML; Dossi, R; Landoni, G; Silvani, P; Silvetti, S; Zangrillo, A, 2015)		1.27
"Levosimendan is a pyridazinone-dinitrile derivative with positive inotropic and vasodilatory effects that has beneficial effects on myocardial performance. "( Levosimendan: The current situation and new prospects.
Henriques-Coelho, T; Leite-Moreira, AF; Lourenço, AP; Moreno, N; Oliveira-Pinto, J; Tavares-Silva, M, 2014)		1.52
"Levosimendan proved to be a safe, effective strategy in our paediatric population."( Experience with levosimendan in 32 paediatric patients.
Martín Herranz, MI; Martínez Roca, C; Vilaboa Pedrosa, C; Yáñez Gómez, P, 2015)		1.22
"Levosimendan is a calcium sensitizer and K(+)-ATP channel opener with inotropic and vasodilatatory effects irrespective of myocardial oxygen consumption, used for treatment of heart failure (HF). "( Effects of levosimendan on heart failure in normotensive patients: does loading dose matter?
Favilli, R; Lunghetti, S; Mondillo, S; Palmerini, E; Söderberg, S, 2015)		1.33
"Levosimendan is a calcium-sensitising ionodilator."( Peri-operative Levosimendan in Patients Undergoing Cardiac Surgery: An Overview of the Evidence.
Bastian, BC; Collins, N; Cottee, DB; James, AN; Li, S; Mejia, R; Shi, WY, 2015)		1.23
"Levosimendan is a non-adrenergic inotropic Ca(+2) sensitizer with not only beneficial hemodynamic properties but also pleiotropic effects, contributing to its cardioprotective and neuroprotective role."( Role of levosimendan in the management of subarachnoid hemorrhage.
Eforakopoulou, M; Georgiadou, M; Katsioula, E; Pavlou, H; Sarafidou, P; Varvarousi, G; Xanthos, T, 2016)		1.29
"Levosimendan is an inotropic agent with cardioprotective and vasodilating properties used for the management of acutely decompensated heart failure. "( Effect of levosimendan therapy on myocardial infarct size and left ventricular function after acute coronary occlusion.
Duvall, E; Haavisto, M; Kentala, R; Knuuti, J; Levijoki, J; Nyman, L; Pietilä, M; Roivainen, A; Saraste, A; Saukko, P; Saunavaara, V; Savunen, T; Stark, C; Strandberg, M; Tarkia, M; Teräs, M; Tolvanen, T; Vähäsilta, T, 2016)		1.35
"Levosimendan is an inodilator developed for treatment of acute heart failure and other cardiac conditions where the use of an inodilator is considered appropriate. "( Levosimendan meta-analyses: Is there a pattern in the effect on mortality?
Harjola, VP; Kivikko, M; Parissis, J; Pollesello, P, 2016)		1.55
"Levosimendan is a new positive inotropic agent having ATP-dependent potassium-channel opening, and calcium-sensitizing effects, which increases cardiac contractility and performance along with vasodilatatory action without increasing myocardial oxygen demand."( Levosimendan. A promising future drug for refractory cardiac failure in children?
Kumar, A; Kushwah, S; Sahana, KS, 2016)		1.47
"Levosimendan is a calcium-sensitizing drug with positive inotropic properties. "( [Use of levosimendan in children].
Mauriat, P; Séguéla, PE; Tafer, N; Thambo, JB, 2016)		1.37
"Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. "( Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper.
Alvarez, J; Brito, D; Farmakis, D; Fedele, F; Fonseca, C; Gal, TB; Gordon, AC; Gotsman, I; Grossini, E; Guarracino, F; Harjola, VP; Hellman, Y; Heunks, L; Ivancan, V; Karavidas, A; Kivikko, M; Lomivorotov, V; Longrois, D; Masip, J; Metra, M; Morelli, A; Nikolaou, M; Papp, Z; Parissis, J; Parkhomenko, A; Poelzl, G; Pollesello, P; Ravn, HB; Rex, S; Ricksten, SE; Riha, H; Schwinger, RHG; Vrtovec, B; Yilmaz, MB; Zielinska, M, 2016)		1.55
"Levosimendan is a pyridazinone-dinitrile derivative, emerged as a potent cardiotonic agent with dual inotropic and vasodilator activities in higher animals. "( A Review on Role of the Calcium Sensitive Inotropic Agent, Levosimendan and Its Metabolites.
Asif, M, 2018)		1.28
"Levosimendan is an inodilator for the treatment of acute decompensated heart failure (HF). "( Anti-thrombotic and pro-fibrinolytic effects of levosimendan in human endothelial cells in vitro.
de Martin, R; Eppel, W; Hohensinner, PJ; Huber, K; Kastl, SP; Kaun, C; Krychtiuk, KA; Maurer, G; Rauscher, S; Seigner, J; Speidl, WS; Stojkovic, S; Wojta, J; Zuckermann, A, 2017)		1.26
"Levosimendan is a positive inotropic drug with vasodilatory properties that is indicated for acute heart failure."( The use of Levosimendan for myocardiopathy due to acute Chagas' disease.
de Albernaz Muniz, RZ; de March Ronsoni, R; Feijó, RV; Filho, WJ; Melo, LH; Moro, A; Schwingel, FL; Weber, S, 2009)		1.19
"Levosimendan is a new calcium sensitizer that enhances the contractile force of the myocardium and exhibits additional vasodilating properties. "( Safety and effectiveness of levosimendan in patients with predominant right heart failure.
Frick, M; Grander, W; Jonetzko, P; Metzler, B; Pachinger, O; Poelzl, G; Roithinger, FX; Ulmer, H; Zwick, RH, 2008)		1.19
"Levosimendan is a calcium-sensitizing drug for the treatment of heart failure. "( The hemodynamic and pharmacokinetic interactions between chronic use of oral levosimendan and digoxin in patients with NYHA Classes II-III heart failure.
Harjola, VP; Jurkko, R; Nieminen, MS; Oikarinen, L; Puttonen, J; Sarapohja, T; Sundberg, S; Toivonen, L, 2008)		1.13
"Levosimendan is a calcium-sensitizing agent with effective inotropic properties. "( First experiences with intraoperative Levosimendan in pediatric cardiac surgery.
Boethig, D; Goerler, H; Huber, D; Osthaus, WA; Sasse, M; Sümpelmann, R; Winterhalter, M, 2009)		1.18
"Levosimendan is a novel agent in the treatment of decompensated heart failure, representing a newer class of medications aimed at increasing calcium sensitivity."( Levosimendan and calcium sensitization of the contractile proteins in cardiac muscle: impact on heart failure.
Economides, C; Kota, B; Prasad, AS; Singh, BN, 2008)		1.38
"Levosimendan is a new cardiac enhancer that exerts positive inotropic effects on the failing heart mediated by calcium sensitization of contractile proteins as well as peripheral vasodilatory effects mediated by opening of ATP-sensitive potassium channels in vascular smooth-muscle cells. "( Levosimendan: from basic science to clinical practice.
Mebazaa, A; Paraskevaidis, I; Parissis, JT; Rafouli-Stergiou, P, 2009)		1.47
"Levosimendan acts as a vasodilator through the opening of ATP-sensitive K(+) channels (K(ATP)) channels. "( Levosimendan induces NO production through p38 MAPK, ERK and Akt in porcine coronary endothelial cells: role for mitochondrial K(ATP) channel.
Caimmi, PP; Grossini, E; Molinari, C; Uberti, F; Vacca, G, 2009)		1.47
"Levosimendan is a compound with vasodilatory and inotropic properties. "( Levosimendan facilitates weaning from cardiopulmonary bypass in patients undergoing coronary artery bypass grafting with impaired left ventricular function.
Eriksson, HI; Heikkinen, LO; Jalonen, JR; Kivikko, M; Kuitunen, AH; Kuttila, KT; Laine, M; Leino, KA; Peräkylä, TK; Salmenperä, MT; Sarapohja, T; Suojaranta-Ylinen, RT; Valtonen, M, 2009)		1.47
"Levosimendan is a novel inodilator agent, which enhances myocardial performance without substantial changes in oxygen consumption. "( Effects of levosimendan on the energy balance: preclinical and clinical evidence.
Nieminen, MS; Papp, Z; Pollesello, P; Vajda, G, 2009)		1.26
"Levosimendan is a promising adjunct in our therapeutic repertoire for the treatment of CF; however, it has not been evaluated in CF patients undergoing non-cardiac surgery."( Prophylactic preoperative levosimendan administration in heart failure patients undergoing elective non-cardiac surgery: a preliminary report.
Drimousis, P; Filis, K; Kapralou, A; Katsaragakis, S; Kofinas, G; Larentzakis, A; Markogiannakis, H; Misthos, P; Theodorou, D, )		0.9
"Levosimendan (LS) is a new inodilator agent that improves cardiac contractility by increasing the sensitivity of troponin C to calcium, which usage in cardiac surgery has been growing in the recent years. "( Timing of levosimendan in cardiac surgery.
Adanir, T; Aksun, M; Aran, G; Gürbüz, A; Karahan, N; Ozgürbüz, U; Oztürk, T; Sencan, A; Yetkin, U, 2009)		1.27
"Levosimendan is a calcium-sensitising inotropic agent and a vasodilator used in the treatment of heart failure. "( Prophylactic treatment with levosimendan: a retrospective matched-control study of patients with reduced left ventricular function.
Kirkeby-Garstad, I; Kolseth, SM; Nordhaug, DO; Sellevold, O; Stenseth, R; Wahba, A, 2009)		1.19
"Levosimendan is a novel calcium sensitizing inotropic agent with anti-apoptotic properties."( Effects of levosimendan in experimental acute coxsackievirus myocarditis.
Kytö, V; Latva-Hirvelä, J; Levijoki, J; Saraste, A; Saukko, P; Vuorinen, T, 2009)		1.19
"Levosimendan is a new inodilatory agent with calcium sensitizing activity. "( Levosimedan improves hemodynamics functions without sympathetic activation in severe heart failure patients: direct evidence from sympathetic neural recording.
Despas, F; Franchitto, N; Galinier, M; Labrunee, M; Pathak, A; Senard, JM; Trouillet, C, 2010)		0.92
"Levosimendan is a calcium sensitizer that is able to enhance myocardial contractility without increasing myocardial oxygen use."( Levosimendan reduces mortality in critically ill patients. A meta-analysis of randomized controlled studies.
Ajello, V; Bignami, E; Biondi-Zoccai, G; Guarracino, F; Landoni, G; Marino, G; Mizzi, A; Prati, P; Zangrillo, A, 2010)		1.4
"Levosimendan is a new calcium sensitizer and K-ATP channel opener, has emerged as an alternative option of pharmacologic inotropic support in patients with decompensated heart failure."( A promising new inotrope: levosimendan.
Duman, D; Fotbolcu, H, 2010)		1.13
"Levosimendan is a calcium sensitizer developed for the treatment of heart failure. "( Absence of mitochondrial activation during levosimendan inotropic action in perfused paced guinea pig hearts as demonstrated by modular control analysis.
Calmettes, G; Deschodt-Arsac, V; Diolez, P; Franconi, JM; Massot, P; Pollesello, P; Raffard, G, 2010)		1.18
"Levosimendan is a 'Ca(2+)sensitiser', which exerts its inotropic effect by increasing the affinity of troponin C for Ca(2+), directly stabilising the Ca(2+)-induced conformation of troponin C. "( Levosimendan - a calcium sensitising agent with potential anti-arrhythmic properties.
Banach, M; Kowalczyk, M; Kozłowski, D; Lip, GY; Mikhailidis, DP; Rysz, J, 2010)		1.48
"Levosimendan is a relatively new inotropic agent. "( Efficacy of levosimendan in patients with chronic heart failure: Does rhythm matter?
Tandoğan, I; Yalta, K; Yilmaz, MB; Yontar, OC, 2010)		1.26
"Levosimendan is a unique therapeutic agent that decreases mortality in acute episodes of decompensated heart failure by increasing myocardial contractility without increasing oxygen consumption or ATP demands, decreasing preload, or decreasing afterload. "( Levosimendan: calcium sensitizer and inodilator.
Fields, AM; Milligan, DJ, 2010)		1.48
"Levosimendan is a novel inotropic agent that enhances cardiac contractility without increasing cellular calcium intake, so that it is not supposed to cause intracellular calcium overload and related arrhythmias. "( Acute effects of levosimendan and dobutamine on QRS duration in patients with heart failure.
Erdem, A; Tandogan, I; Yalta, K; Yilmaz, MB; Yontar, OC, 2010)		1.24
"Levosimendan is a promising new inodilator agent but its effectiveness in peripartum cardiomyopathy (PPCM) has not been tested in a clinical trial. "( Effect of levosimendan and predictors of recovery in patients with peripartum cardiomyopathy, a randomized clinical trial.
Akgün, T; Biteker, M; Duran, NE; Gökdeniz, T; Gündüz, S; Kahveci, G; Kaya, H; Õzkan, M; Tanboğa, HÎ; Yildiz, M, 2011)		1.29
"Levosimendan is a calcium sensitizer with positive inotropic and vasodilating properties. "( The protective effects of levosimendan on ischemia/reperfusion injury and apoptosis.
Beiras-Fernandez, A; Mutlak, H; Scheiermann, P; Weis, F, 2011)		1.22
"Levosimendan is an inotropic agent with clinical indications for open-heart surgery."( Levosimendan decreases intracranial pressure after hypothermic circulatory arrest in a porcine model.
Eija, R; Fredrik, Y; Hannu, T; Jensen, H; Jussi, M; Kai, K; Kirsi, A; Matti, P; Tatu, J; Tuomas, M; Vesa, A, 2011)		1.41
"Levosimendan is a new drug used in heart failure though it is limited by the systemic hypotension, which develops with intravenous administration."( Management of acute cardiac failure by intracoronary administration of levosimendan.
Beggino, C; Caimmi, PP; Crosio, E; Giustini, G; Grossini, E; Kapetanakis, EI; Micalizzi, E; Molinari, C; Reposo, G; Vacca, G, 2011)		1.08
"Levosimendan is a cardiovascular drug for the treatment of acute and decompensated heart failure. "( Multiple signalling pathways underlie the protective effect of levosimendan in cardiac myocytes.
Galatou, E; Lazou, A; Makridou, Z; Markou, T, 2011)		1.16
"Levosimendan is an extensively investigated inodilator showing also cardioprotective and antiinflammatory effects. "( Levosimendan inhibits release of reactive oxygen species in polymorphonuclear leukocytes in vitro and in patients with acute heart failure and septic shock: a prospective observational study.
Bellmann, R; Bertocchi, C; Bijuklic, K; Dunzendorfer, S; Hasslacher, J; Joannidis, M; Kountchev, J, 2011)		1.49
"Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use."( Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies.
Bignami, E; Biondi-Zoccai, G; Greco, M; Greco, T; Guarracino, F; Landoni, G; Morelli, A; Zangrillo, A, 2012)		1.21
"Levosimendan is a calcium-sensitizing inotrope that may support cardiac output, but little is known regarding its differential hemodynamic effects in asphyxiated neonates."( Differential hemodynamic effects of levosimendan in a porcine model of neonatal hypoxia-reoxygenation.
Bigam, D; Cheung, PY; Esch, J; Joynt, C; Lee, TF; Li, YQ; Manouchehri, N; Vento, M, 2012)		1.13
"Levosimendan is a novel positive inotropic agent which, improves myocardial contractility through its calcium-sensitizing action, without causing an increase in myocardial oxygen demand. "( [Levosimendan treatment of severe acute congestive heart failure refractory to dobutamine/milrinone in children].
Jovicić, B; Kosutić, J; Nikolić, L; Prijić, S; Rakić, S; Stajević, M; Vukomanović, V, 2011)		1.44
"Levosimendan is a novel inotropic agent claimed to improve myocardial contractility by a calcium-sensitizing effect. "( A dose-response study of levosimendan in a porcine model of acute ischaemic heart failure.
Aro, S; Høydal, M; Kirkeby-Garstad, I; Kolseth, SM; Nordgaard, H; Nordhaug, D; Rognmo, Ø; Wahba, A, 2012)		1.23
"Levosimendan (Levo) is an inodilator improving cardiac output (CO) and reducing afterload in heart failure. "( Levosimendan infusion improves cardiac output but not blood pressure in a rodent model of severe metoprolol toxicity.
Graudins, A; Kalam, Y, 2012)		1.5
"Levosimendan is an inodilator indicated for acute heart failure (AHF). "( The clinical effects of levosimendan are not attenuated by sulfonylureas.
Colucci, WS; Kivikko, M; Mebazaa, A; Nieminen, MS; Pohjanjousi, P; Pollesello, P; Teerlink, JR, 2012)		1.23
"Levosimendan (LEVO) is a new calcium sensitizer with positive inotropic and vasodilating properties that represents a new pharmacological class of inotropic drugs that stimulate elevated cardiac output. "( Beneficial pharmacological effects of levosimendan on antioxidant status of acute inflammation induced in paw of rat: involvement in inflammatory mediators.
Albayrak, A; Aydin, A; Bayir, Y; Cadirci, E; Ferah, I; Halici, Z; Karakus, E; Odaci, E; Unal, D, 2013)		1.21
"Levosimendan is a relatively recent inodilatory agent, presenting superior outcomes in comparison with traditional inotropes."( Economic evaluation of levosimendan versus dobutamine for the treatment of acute heart failure in Italy.
Apajasalo, M; D'Ambrosi, A; Fedele, F; Lucioni, C; Mazzi, S; Pollesello, P, 2012)		1.16
"Levosimendan is a new calcium sensitizer with additional vasodilatory properties developed for the short-term intravenous treatment of congestive heart failure. "( Pharmacokinetics of levosimendan and its metabolites during and after a 24-hour continuous infusion in patients with severe heart failure.
Antila, S; Eha, J; Kivikko, M; Lehtonen, L; Pentikäinen, PJ, 2002)		1.18
"Levosimendan is a potent calcium sensitiser with vasodilating properties that has been shown to provide symptomatic and haemodynamic improvement with no increase in oxygen consumption."( Pharmacotherapeutic approaches for decompensated heart failure: a role for the calcium sensitiser, levosimendan?
Borghi, C; Greenberg, B; Perrone, S, 2003)		1.01
"Levosimendan is a new and relevant calcium sensitizer developed for the short-term intravenous treatment of congestive heart failure."( [Levosimendan: a new option in the pharmacologic management of cardiac insufficiency].
Campos Lara, MG; Carballal-Sanjurjo, JC; Del-Razo, OE; Palma-Aguirre, JA, )		1.13
"Levosimendan is a new agent for the treatment of acute heart failure. "( Levosimendan: a new dual-action drug in the treatment of acute heart failure.
Erhardt, L; Mebazaa, A, 2003)		1.44
"Levosimendan, is a new calcium sensitiser with 2 major effects. "( [Is levosimendan an inoprotective drug in patients with acute coronary syndrome undergoing surgical revascularization?].
Blome, M; Boldt, J; Isgro, F; Lang, J; Lehmann, A, 2003)		1.31
"Levosimendan is a promising calcium sensitizer that potentially could be useful in settings of pulmonary vasoconstriction and right ventricular dysfunction. "( Effects of levosimendan on right ventricular function and ventriculovascular coupling in open chest pigs.
Herijgers, P; Leather, HA; Segers, P; Vandermeersch, E; Ver Eycken, K; Wouters, PF, 2003)		1.23
"Levosimendan is a calcium sensitizer with no major inhibition of PDE at clinically relevant doses."( The role of Ca++-sensitizers for the treatment of heart failure.
Boldt, J; Kirchner, J; Lehmann, A, 2003)		0.8
"Levosimendan is a novel calcium sensitizing agent in development for the treatment of acute and chronic heart failure. "( Levosimendan: implications for clinicians.
McBride, BF; White, CM, 2003)		1.44
"Levosimendan is a representative of this new class recently launched in the Portuguese market."( Levosimendan: a new approach for the treatment of patients with severe heart failure. A brief summary based on a clinical case.
Dias, B; Morais, J; Pontes, N, )		1.17
"Levosimendan is a new vasodilator agent with properties which improve cardiac contractility by calcium sensitization. "( Considerations on the efficacy and safety of levosimendan in ischemic heart failure.
Nieminen, MS; Sandell, EP, 2003)		1.13
"Levosimendan (Simdax) is a calcium-sensitising drug that stabilises the troponin molecule in cardiac muscle, thus prolonging its effects on contractile proteins, with concomitant vasodilating properties. "( Levosimendan: a review of its use in the management of acute decompensated heart failure.
Innes, CA; Wagstaff, AJ, 2003)		1.44
"Levosimendan is a recently developed drug which is not yet approved for clinical routine use in Germany. "( [Levosimendan. Clinical indications of a new vasoactive substance].
Borges, A; Braun, JP; Dohmen, P; Döpfmer, U; Kastrup, M; Kox, W; Roots, I; Schneider, M; Spies, C, 2004)		1.4
"Levosimendan (LS) is a new calcium sensitizer that exerts positive inotropic effects without increasing intracellular cAMP or Ca2+ at therapeutic doses and therefore may avoid major limitations of beta-adrenergic agents. "( [Levosimendan in cardiology and intensive care medicine].
Delle Karth, G; Heinz, G, 2004)		1.4
"Levosimendan (Simdax) is a novel intravenous agent that exerts inotropic effects through sensitization of myofilaments to calcium and vasodilator effects by opening ATP-dependent potassium channels on vascular smooth muscle."( Levosimendan: first in a new class of inodilator for acute and chronic severe heart failure.
Cleland, JG; McGowan, J; Nikitin, N, 2004)		1.36
"Levosimendan is a novel calcium sensitizer that increases contraction force without change in intracellular calcium ([Ca2+]i); milrinone is a phosphodiesterase inhibitor that exerts a positive inotropic effect by increasing [Ca2+]i. "( Effects of levosimendan and milrinone on oxygen consumption in isolated guinea-pig heart.
Haikala, H; Kaheinen, P; Levijoki, J; Pollesello, P, 2004)		1.23
"Levosimendan is a calcium sensitizer that increases the contractility of the myofilaments and is considered not to affect cardiac electrophysiology. "( The calcium sensitizer levosimendan and cardiac arrhythmias: an analysis of the safety database of heart failure treatment studies.
Lehtonen, L; Lilleberg, J; Toivonen, L; Ylönen, V, 2004)		1.18
"Levosimendan is a new calcium sensitizer, which enhances myocardial contractility while simultaneously having vasodilatory and cardioprotective effects. "( Levosimendan in patients with cardiogenic shock undergoing surgical revascularization: a case series.
Boldt, J; Isgro, F; Kiessling, AH; Lang, J; Lehmann, A, 2004)		1.44
"Levosimendan is a novel drug developed for treatment of decompensated heart failure. "( Effect of levosimendan on balance between ATP production and consumption in isolated perfused guinea-pig heart before ischemia or after reperfusion.
Eriksson, O; Haikala, H; Pollesello, P, 2004)		1.24
"Levosimendan is a distinct calcium sensitizer, as it stabilizes the interaction between calcium and troponin C by binding to troponin C in a calcium-dependent manner, improving inotropy without adversely affecting lusitropy."( Levosimendan, a new calcium-sensitizing inotrope for heart failure.
Ng, TM, 2004)		1.36
"Levosimendan is a novel calcium sensitiser which has been discovered by using cardiac troponin C (cTnC) as target protein."( The contractile apparatus as a target for drugs against heart failure: interaction of levosimendan, a calcium sensitiser, with cardiac troponin c.
Pollesello, P; Solaro, RJ; Sorsa, T, 2004)		1.03
"Levosimendan is a new calcium sensitizer developed for the treatment of congestive heart failure. "( Levosimendan: a new inodilatory drug for the treatment of decompensated heart failure.
Kivikko, M; Lehtonen, L, 2005)		1.44
"Levosimendan is a calcium-sensitizing agent and an inodilator under current investigation in the treatment of decompensated heart failure. "( Effects of intravenous levosimendan on human coronary vasomotor regulation, left ventricular wall stress, and myocardial oxygen uptake.
Chatterjee, K; Foster, E; Gerber, IL; Jordan, MV; Kostal, M; McKeown, B; Michaels, AD; Vakharia, KT, 2005)		1.18
"Levosimendan is a new Ca2+-sensitizer for the treatment of acutely decompensated heart failure that has proved to be effective during the decompensation of chronic heart failure and acute myocardial infarction."( Pharmacological mechanisms contributing to the clinical efficacy of levosimendan.
Csapó, K; Edes, I; Haikala, H; Papp, Z; Pollesello, P, 2005)		1.04
"Levosimendan is a new inodilator. "( Levosimendan: a calcium-sensitizing agent for the treatment of patients with decompensated heart failure.
Lehtonen, L, 2004)		1.44
"Levosimendan is a novel inotropic vasodilator agent."( [The novelty in the treatment of heart failure].
Reingardiene, D, 2005)		0.81
"Levosimendan is a calcium sensitizer that demonstrates enhanced myocardial contractility. "( Effects of levosimendan on left ventricular functional remodelling and exercise intolerance: a tissue Doppler study.
Cam, N; Kasikcioglu, E; Kasikcioglu, HA; Okmen, E; Tartan, Z; Unal, S; Uyarel, H, )		1.04
"Levosimendan proved to be a 1300-fold more potent and a 90-fold more selective PDE III inhibitor (IC50 for PDE III 1.4 nM, and IC50 for PDE IV 11 microM, selectivity factor approximately 8000) than enoximone (IC50 for PDE III 1.8 microM, and IC50 for PDE IV 160 microM, selectivity factor approximately 90)."( Two inotropes with different mechanisms of action: contractile, PDE-inhibitory and direct myofibrillar effects of levosimendan and enoximone.
Bak, I; Borbély, A; Edes, I; Haikala, H; Levijoki, J; Papp, Z; Pollesello, P; Szilágyi, S; Tósaki, A, 2005)		1.02
"Levosimendan is a new calcium sensitizer with inodilatory properties. "( Levosimendan in cardiac surgery.
Harjola, VP; Siirilä-Waris, K; Suojaranta-Ylinen, R, 2005)		1.44
"Levosimendan is a novel inotropic agent that has several mechanisms of action including calcium sensitization, and is undergoing clinical trials at present."( The myofilament force-calcium relationship as a target for positive inotropic therapy in congestive heart failure.
MacGowan, GA, 2005)		0.81
"Levosimendan is a novel calcium-sensitising agent that has been shown to have beneficial inotropic, metabolic and vasodilatory effects in the treatment of acute and advanced chronic heart failure. "( Levosimendan for the treatment of acute heart failure syndromes.
Adamopoulos, S; Farmakis, D; Filippatos, G; Kremastinos, D; Paraskevaidis, I; Parissis, JT, 2005)		1.44
"Levosimendan is a novel compound recently approved for the management of acute heart failure in Sweden and several European countries. "( Levosimendan: dual mechanisms for acute heart failure...and beyond?
Akhter, MW; Ng, TM, 2005)		1.44
"Levosimendan is a calcium sensitizer that, besides increasing contractility, has a vasodilating effect due to the activation of K(ATP) channels, being both mechanisms responsible for an advantageous therapeutic option."( [Levosimendan: a new strategy in the treatment of heart failure].
Arias Sánchez, EA; Chacón Mercado, MA; García López, SM; González-Chon, O; Vega Zapata, RE, )		1.13
"Levosimendan is a new inodilator that improves cardiac contractility by sensitizing troponin C to calcium. "( [Successful use of levosimendan in a patient with cardiogenic shock complicating acute myocardial infarction].
Anis, L; Habib, H; Iheb, L; Moufida, H; Mustapha, F; Nedia, B, 2005)		1.2
"Levosimendan is a new Ca-sensitizing drug with combined positive inotropic and vasodilatory effects that offers new therapeutic possibilities in patients with severe heart failure. "( Effects of levosimendan on left ventricular diastolic function after primary angioplasty for acute anterior myocardial infarction: a Doppler echocardiographic study.
Battagliese, A; Benedetti, G; De Luca, L; Di Roma, A; Fedele, F; Proietti, P; Sardella, G, 2006)		1.24
"Levosimendan is an inotropic and vasodilator drug that has proved to be useful in cardiogenic shock. "( Effects of levosimendan in normodynamic endotoxaemia: a controlled experimental study.
Barán, M; Canales, HS; Dubin, A; Edul, VS; Estenssoro, E; Maskin, B; Murias, G; Pozo, MO; Sottile, JP, 2006)		1.24
"Levosimendan is a calcium sensitizer with positive inotropic and vasodilatory effects and has been developed for treatment of decompensated heart failure."( Successful administration of levosimendan in a patient with low-gradient low-output aortic stenosis.
Hoefer, D; Hoermann, C; Jonetzko, P; Laufer, G; Poelzl, G, 2006)		1.1
"Levosimendan is a new calcium sensitizer with positive inotropic properties. "( Cardiogenic shock after primary percutaneous coronary intervention: Effects of levosimendan compared with dobutamine on haemodynamics.
Abreu-González, P; Domínguez-Rodríguez, A; Ferrer-Hita, JJ; García-González, MJ; Muñoz, MB, 2006)		1.12
"Levosimendan is a potent inotropic and vasodilator drug used in the treatment of decompensated heart failure. "( Potassium channel-related relaxation by levosimendan in the human internal mammary artery.
Demirkilic, U; Nacitarhan, C; Seyrek, M; Yildirim, V; Yildiz, O, 2006)		1.15
"Levosimendan is a new calcium sensitizer and K-ATP channel opener. "( Evidence-based use of levosimendan in different clinical settings.
Colucci, WS; De Luca, L; Gheorghiade, M; Massie, BM; Nieminen, MS, 2006)		1.19
"Levosimendan is a calcium-sensitizing agent and inodilator working via potassium channels, which is under current investigation in the treatment of heart failure. "( Potassium channels in the vasodilating action of levosimendan on the human umbilical artery.
Nacitarhan, C; Seyrek, M; Yildiz, O, 2006)		1.14
"Levosimendan is an inotropic agent that is effective in the treatment of heart failure. "( [Hemodynamic effects of levosimendan compared with dobutamine in patients with low cardiac output after cardiac surgery].
Alvarez, J; Bouzada, M; Caruezo, V; Fernández, AL; García-Bengoechea, JB; Ginesta, V; González-Juanatey, JR; Rodríguez, J; Rubio, J; Taboada, M, 2006)		1.19
"Levosimendan is a novel inodilator drug developed for the treatment of heart failure. "( Vasorelaxing effect of levosimendan against 5-hydroxytryptamine-induced contractions in isolated human conduit bypass grafts.
Hegedus, Z; Krassói, I; Kun, A; Papp, JG; Pataricza, J; Szolnoky, J; Varró, A, 2006)		1.19
"Levosimendan is a novel inodilator that improves central haemodynamics and symptoms of patients with decompensated chronic heart failure. "( Effects of serial levosimendan infusions on left ventricular performance and plasma biomarkers of myocardial injury and neurohormonal and immune activation in patients with advanced heart failure.
Adamopoulos, S; Farmakis, D; Filippatos, G; Iliodromitis, E; Kremastinos, DT; Panou, F; Paraskevaidis, I; Parissis, JT, 2006)		1.21
"Levosimendan is a positive inotropic drug with vasodilator action and proposed myocardioprotective properties. "( Effects of levosimendan on myocardial infarct size and hemodynamics in a closed-chest porcine ischemia-reperfusion model.
Berg, JS; Busk, M; Kristensen, J; Maeng, M; Mortensen, UM; Nielsen, TT; Nielsen-Kudsk, JE, 2006)		1.24
"Levosimendan is a novel inodilator that beneficially affects hemodynamics and left ventricular systolic and diastolic function in patients with advanced heart failure."( Effects of levosimendan on right ventricular function in patients with advanced heart failure.
Bistola, V; Farmakis, D; Filippatos, G; Kourea, K; Kremastinos, D; Nikolaou, M; Panou, F; Paraskevaidis, I; Parissis, JT, 2006)		1.17
"Levosimendan is a calcium sensitizer that is currently in the focus of intensive care medicine because it may be superior to standard inotropic agents in the treatment of acute myocardial insufficiency. "( [Role of Levosimendan in intensive care treatment of myocardial insufficiency].
Bröking, K; Ertmer, C; Lange, M; Morelli, A; Rehberg, S; Van Aken, H; Westphal, M, 2007)		1.27
"Levosimendan is a novel calcium sensitizer with vasodilating properties and a complex mechanism of action."( Effect of levosimendan on ventricular arrhythmias and prognostic autonomic indexes in patients with decompensated advanced heart failure secondary to ischemic or dilated cardiomyopathy.
Flevari, P; Kourea, K; Kremastinos, DT; Leftheriotis, D; Panou, F; Parissis, JT, 2006)		1.18
"Levosimendan is a novel positive inotropic calcium sensitizer agent used in acute heart failure. "( Effect of levosimendan on E/E' ratio in patients with ischemic heart failure.
Akilli, A; Akin, M; Duygu, H; Ergene, O; Nalbantgil, S; Nazli, C; Ozerkan, F; Zoghi, M, 2008)		1.26
"Levosimendan is a new positive inotropic agent having ATP-dependent potassium-channel-opening and calcium-sensitizing effects."( A review of levosimendan in the treatment of heart failure.
Cam, N; Kasikcioglu, HA, 2006)		1.16
"Levosimendan is a calcium sensitiser developed for the treatment of congestive heart failure. "( Effect of severe renal failure and haemodialysis on the pharmacokinetics of levosimendan and its metabolites.
Häkkinen, S; Harjola, VP; Kantele, S; Kivikko, M; Koskinen, P; Pentikäinen, PJ; Puttonen, J, 2007)		1.12
"Levosimendan (LS) is a novel calcium sensitizer drug that enhances cardiac contractility without increasing myocardial oxygen consumption, and induces vasodilatation. "( Successful use of levosimendan in a patient during cardiopulmonary bypass.
Erer, D; Iriz, E; Ozdogan, ME; Ozkose, Z; Unal, Y; Zor, H, )		1
"Levosimendan is a relatively new Ca(2+) sensitizer which offers haemodynamic and symptomatic improvement by combining a positive inotropic action via Ca(2+) sensitization and a vasodilatory effect via adenosine triphosphate(ATP)-sensitive K(+) (K(ATP)), Ca(2+)-activated K(+) (K(Ca)(2+)) and voltage-dependent K(+) (K(V)) channels activation."( Levosimendan: beyond its simple inotropic effect in heart failure.
Antoniades, C; Koumallos, N; Marinou, K; Stefanadis, C; Tousoulis, D, 2007)		1.38
"Levosimendan is a new calcium sensitizer with inotropic and vasodilatory actions mediated by the sensitization of contractile proteins to calcium, opening of potassium channels and inhibition of phosphodiesterase-3. "( The use of levosimendan in comparison and in combination with dobutamine in the treatment of decompensated heart failure.
Cavusoglu, Y, 2007)		1.25
"Levosimendan is a calcium sensitizer with a positive inotropic effect without increasing oxygen consumption. "( Experiences of levosimendan as an inotropic agent in conjunction with passive containment surgery.
Bredin, F; Franco-Cereceda, A, 2007)		1.23
"Levosimendan is a new inotropic vasodilator for the treatment of decompensated heart failure. "( Haemodynamic effects of levosimendan for low cardiac output after cardiac surgery: a case series.
Hassoulas, J; Linardakis, M; Malliotakis, P; Xenikakis, T, )		0.98
"Levosimendan is a myocardial calcium sensitiser and potassium-ATP channel opener Levosimendan has been used in critically ill patients in various conditions to support myocardial function as an inotrope, lusitrope and vasodilator. "( Myocardial depression associated with pneumococcal septic shock reversed by levosimendan.
Bihari, D; Ramaswamykanive, H; Solano, TR, 2007)		1.12
"Levosimendan (Simdax) is an approved drug in approximately 40 countries and currently in phase III clinical studies in the USA and Europe. "( A strategy for high-throughput analysis of levosimendan and its metabolites in human plasma samples using sequential negative and positive ionization liquid chromatography/tandem mass spectrometric detection.
El-Shourbagy, TA; Gage, EM; Ji, QC; Zhang, J, 2007)		1.15
"Levosimendan is a new calcium sensitizer with positive inotropic properties. "( Effects of levosimendan versus dobutamine on left ventricular diastolic function in patients with cardiogenic shock after primary angioplasty.
Abreu-Gonzalez, P; Dominguez-Rodriguez, A; Garcia-Gonzalez, MJ; Samimi-Fard, S, 2008)		1.26
"Levosimendan is a promising new inotrope. "( Efficacy and safety of perioperative infusion of levosimendan in patients with compromised cardiac function undergoing open-heart surgery: importance of early use.
Antoniou, T; Degiannis, D; Geroulanos, S; Kriaras, I; Papadopoulos, K; Stavridis, G; Tasouli, A, 2007)		1.15
"Levosimendan is a safe and efficient choice in the management of low-output syndrome during and after open-heart surgery. "( Efficacy and safety of perioperative infusion of levosimendan in patients with compromised cardiac function undergoing open-heart surgery: importance of early use.
Antoniou, T; Degiannis, D; Geroulanos, S; Kriaras, I; Papadopoulos, K; Stavridis, G; Tasouli, A, 2007)		1.15
"Levosimendan is a novel drug used for inotropic support in heart failure, but its efficacy in local anesthetic-induced myocardial depression is not known. "( The effects of levosimendan on myocardial function in ropivacaine toxicity in isolated guinea pig heart preparations.
Christ, T; Deussen, A; Hübler, M; Koch, T; Rasche, B; Rasche, S; Ravens, U; Stehr, SN; Wettwer, E, 2007)		1.23
"Levosimendan is an effective inotropic drug in ropivacaine-induced myocardial depression and levosimendan myocardial sensitivity, and efficacy was not affected by the local anesthetic. "( The effects of levosimendan on myocardial function in ropivacaine toxicity in isolated guinea pig heart preparations.
Christ, T; Deussen, A; Hübler, M; Koch, T; Rasche, B; Rasche, S; Ravens, U; Stehr, SN; Wettwer, E, 2007)		1.23
"Levosimendan (LEV) is a new inodilator, whose mechanism of action includes calcium sensitization of contractile proteins and the opening of ATP-dependent potassium channels."( Pharmacological preconditioning by levosimendan is mediated by inducible nitric oxide synthase and mitochondrial KATP channel activation in the in vivo anesthetized rabbit heart model.
Das, B; Sarkar, C, 2007)		1.09
"Levosimendan is a novel calcium-sensitising agent that has been proposed as a potentially valuable inotrope for the treatment of acute or decompensated severe heart failure. "( Is there a place for levosimendan in the intensive care unit?
Bagshaw, SM; Bradford, C; Delaney, A; Lee, R; McCaffrey, J, 2007)		1.2
"Levosimendan is a calcium-sensitizing drug that enhances myocardial contractility without increasing intracellular calcium. "( Levosimendan in patients with acute myocardial ischaemia undergoing emergency surgical revascularization.
Boldt, J; Isgro, F; Kiessling, AH; Lehmann, A; Thaler, E; Zeitler, C, 2008)		1.46
"Levosimendan is an inotropic agent used in the treatment of heart failure. "( Treatment of experimental verapamil poisoning with levosimendan utilizing a rodent model of drug toxicity.
Graudins, A; Najafi, J; Rur-SC, MP, 2008)		1.15
"Levosimendan is an inodilatory drug with hemodynamic effects in patients with decompensated chronic heart failure."( Evaluation of the clinical, hemodynamic and neurohormonal response to levosimendan administration in decompensated heart failure patients. One-month follow-up.
Brito, D; Madeira, H; Matias, JS; Sargento, L, )		0.92
"Levosimendan is a novel positive inotropic calcium sensitiser agent used in acute left heart failure. "( Effect of levosimendan on right ventricular systolic and diastolic functions in patients with ischaemic heart failure.
Akilli, A; Akin, M; Duygu, H; Ergene, O; Nalbantgil, S; Nazli, C; Ozerkan, F; Yildiz, A; Zoghi, M, 2008)		1.26
"Levosimendan is a relatively new cardiac inotropic agent with calcium sensitizing activity. "( Levosimendan improves renal function in patients with acute decompensated heart failure: comparison with dobutamine.
Erdem, A; Karadas, F; Tandogan, I; Turgut, OO; Yalta, K; Yilmaz, A; Yilmaz, MB; Yontar, C, 2007)		1.46
"Levosimendan is an established substance in the treatment of acute heart failure in several countries despite disappointing findings concerning a possible survival benefit in two recent clinical trials. "( Levosimendan: current status and future prospects.
Archan, S; Toller, W, 2008)		1.46
"Levosimendan is a novel agent used in the treatment of patients with decompensated heart failure to enhance cardiac contractility. "( Repeated infusions of levosimendan: well tolerated and improves functional capacity in decompensated heart failure - a single-centre experience.
Best, M; Dembo, L; Driscoll, GO; Parle, NM; Thomas, MD, 2008)		1.2
"Levosimendan is a vasodilator used in the treatment of acute heart failure. "( Pharmacokinetics of intravenous levosimendan and its metabolites in subjects with hepatic impairment.
Häkkinen, S; Kantele, S; Kivikko, M; Pentikäinen, PJ; Puttonen, J; Ramela, M; Ruck, A, 2008)		1.18
"Levosimendan is a new inodilatory agent that enhances cardiac contractility via Ca(2+) sensitization and induces vasodilation through the activation of KATP/BKCa."( Levosimendan in decompensated heart failure patients: efficacy in a Brazilian cohort. Results of the BELIEF study.
Albuquerque, D; Baima, J; Barretto, AC; Bocchi, EA; Lage, S; Moreira, Mda C; Rassi, S; Ribeiro, JP; Vilas-Boas, F, 2008)		1.46
"Levosimendan is a novel positive inotropic drug targeted to increase contraction force of the heart through its calcium-dependent binding to troponin C (cTnC). "( Troponin C-mediated calcium sensitization induced by levosimendan does not impair relaxation.
Etemadzadeh, E; Haikala, H; Levijoki, J; Lindén, IB; Nissinen, E, 1995)		1.09
"Levosimendan proved to be a potent cardioto"( Cardiovascular effects of the calcium sensitizer, levosimendan, in heart failure induced by rapid pacing in the presence of aortic constriction.
Papp, JG; Udvary, E; Végh, A, 1995)		1.02
"Levosimendan is a novel inodilator that increases the calcium sensitivity of troponin C in a calcium-dependent way. "( Hemodynamic and neurohumoral effects of levosimendan, a new calcium sensitizer, at rest and during exercise in healthy men.
Lehtonen, L; Lilleberg, J; Nieminen, MS; Sundberg, S, 1995)		1.11
"Levosimendan is a new calcium-sensitiser intended for the treatment of congestive heart failure. "( Haemodynamic dose-efficacy of levosimendan in healthy volunteers.
Akkila, J; Häyhä, M; Lilleberg, J; Nieminen, MS; Sundberg, S, 1994)		1.13
"Simendan is a novel cardiotonic drug with mixed properties, including calcium sensitization. "( Hemodynamic effects of the novel cardiotonic drug simendan: echocardiographic assessment in healthy volunteers.
Leikola-Pelho, T; Lilleberg, JM; Nieminen, MS; Sundberg, S, 1994)		1.98
"Levosimendan is a new phosphodiesterase inhibitor with calcium-sensitizing properties."( Functional and antiischaemic effects of the phosphodiesterase inhibitor levosimendan in isolated rabbit hearts.
Acar, D; Klaus, W; Rösen, R; Rump, AF, )		0.84
"Levosimendan is an inotrope with coronary dilator activity, showing antiischaemic effects in isolated rabbit hearts. "( Functional and antiischaemic effects of the phosphodiesterase inhibitor levosimendan in isolated rabbit hearts.
Acar, D; Klaus, W; Rösen, R; Rump, AF, )		0.92
"Levosimendan is a new inodilatory agent that sensitizes troponin-C in heart muscle cells to calcium, thus improving contractility. "( Pharmacokinetics of levosimendan in healthy volunteers and patients with congestive heart failure.
Antila, S; Hayha, M; Heikkinen, P; Lehtonen, LA; Ottoila, P; Pentikainen, PJ; Sandell, EP, 1995)		1.16
"Levosimendan is a new calcium-sensitizing drug intended for congestive heart failure."( The CYP3A4 inhibitor intraconazole does not affect the pharmacokinetics of a new calcium-sensitizing drug levosimendan.
Antila, S; Honkanen, T; Lehtonen, L; Neuvonen, PJ, 1998)		0.99
"Levosimendan is a pyridazinone-dinitrile derivative belonging to a new class of cardiac inotropic drugs, Ca++ sensitizers. "( Levosimendan, a calcium sensitizer in cardiac muscle, induces relaxation in coronary smooth muscle through calcium desensitization.
Bowman, P; Haikala, H; Paul, RJ, 1999)		1.42
"Levosimendan is a new calcium sensitizer, acting calcium-dependently on cardiac troponin C. "( Integrated pharmacokinetics and pharmacodynamics of the novel calcium sensitizer levosimendan as assessed by systolic time intervals.
Antila, S; Häyhä, M; Lehtonen, L; Scheinin, H; Sundberg, S; Virtanen, M, 1998)		1.08
"Levosimendan is a new myofilament calcium (Ca2+) sensitizer that increases myocardial contractility by stabilizing the Ca2+-bound conformation of troponin C. "( Levosimendan enhances cardiac performance after cardiopulmonary bypass: a prospective, randomized placebo-controlled trial.
Aggarwal, A; Montgomery, MW; Nicolosi, AC; Nijhawan, N; Pagel, PS; Warltier, DC, 1999)		1.42
"Levosimendan is a new inodilator, whose mechanism of action includes calcium sensitization of contractile proteins and the opening of ATP-dependent potassium channels. "( Levosimendan: A promising agent for the treatment of hospitalized patients with decompensated heart failure.
Lehtonen, L, 2000)		1.42
"Levosimendan is a calcium sensitizer for treatment of acute decompensated heart failure."( Hemodynamic and neurohumoral effects of continuous infusion of levosimendan in patients with congestive heart failure.
Akkila, J; Hasenfuss, G; Kleber, FX; Lehtonen, LA; Mitrovic, V; Nieminen, MS; Nyquist, O; Remme, WJ, 2000)		1.1
"Levosimendan is an inodilatory drug that mediates its cardiac effect by the calcium sensitization of contractile proteins. "( Binding of levosimendan, a calcium sensitizer, to cardiac troponin C.
Abbott, MB; Abusamhadneh, E; Annila, A; Drakenberg, T; Heikkinen, S; Kilpelainen, I; Laakso, T; Pollesello, P; Rosevear, PR; Serimaa, R; Sorsa, T; Tilgmann, C, 2001)		1.22
"Levosimendan (Simdax) is a new inodilator developed specifically for the treatment of decompensated heart failure. "( Levosimendan: a parenteral calcium-sensitising drug with additional vasodilatory properties.
Lehtonen, LA, 2001)		1.43
"Levosimendan is a novel inodilator that improves cardiac contractility by sensitizing troponin C to calcium. "( Effects of levosimendan, a novel inotropic calcium-sensitizing drug, in experimental septic shock.
Konrad, D; Oldner, A; Rossi, P; Rudehill, A; Wanecek, M; Weitzberg, E, 2001)		1.22
"Levosimendan is a new calcium sensitizer developed for the short-term intravenous treatment of congestive heart failure. "( Pharmacodynamics and safety of a new calcium sensitizer, levosimendan, and its metabolites during an extended infusion in patients with severe heart failure.
Antila, S; Eha, J; Kivikko, M; Lehtonen, L; Pentikäinen, PJ, 2002)		1.11
"Levosimendan is a new inotropic and vasodilator agent. "( Levosimendan: a new era for inodilator therapy for heart failure?
Cleland, JG; McGowan, J, 2002)		1.43

Effects

Levosimendan has a calcium-sensitizing effect in the myocardium and opens ATP-sensitive potassium channels. Simendan also has a vasodilatation effect, which causes coronary artery resistance and venous volume blood vessel relax, thereby improving coronary blood supply.

Levosimendan has anti-ischaemic effects, improves myocardial contractility and increases systemic, pulmonary and coronary vasodilatation. Simendan causes coronary artery resistance and venous volume blood vessel relax, thereby improving coronary blood supply.

ExcerptReferenceRelevance
"Levosimendan has a long-acting metabolite with a half-life of approximately 80 h."( Pre-bypass levosimendan in ventricular dysfunction-effect on right ventricle.
Ahlawat, V; Kumar, D; Kundu, A; Prakash, A; Yadav, A; Yadava, OP, 2021)		1.46
"Levosimendan has a calcium-sensitizing effect in the myocardium and opens ATP-sensitive potassium channels (K"( Levosimendan prevents bronchoconstriction and adverse respiratory tissue mechanical changes in rabbits.
Babik, B; Balogh, AL; Fodor, GH; Ivankovitsne-Kiss, O; Petak, F; Sudy, R, 2017)		1.57
"Simendan also has a vasodilatation effect, which causes coronary artery resistance and venous volume blood vessel relax, thereby improving coronary blood supply."( The efficacy of simendan in the treatment of acute heart failure and its impact on NT-proBNP.
Li, J; Li, Y; Wang, XY; Yang, F; Yang, J; Yang, ZY; Yuan, P, 2019)		1.58
"Levosimendan has a unique dual mechanism of action by enhancing cardiac contractility and causing peripheral vasodilatation. "( Novel biologic mechanisms of levosimendan and its effect on the failing heart.
Andreadou, I; Bistola, V; Filippatos, G; Kremastinos, DT; Paraskevaidis, I; Parissis, JT, 2008)		1.19
"Levosimendan has a cardioprotective effect when administered before ischemia in ischemia-reperfusion injury. "( Levosimendan attenuates reperfusion injury in an isolated perfused rat heart model.
Gok, S; Nese, N; Ozturk, T, 2010)		1.48
"Levosimendan has a better profile of security than its predecessors (amrinone and milrinone), improves the haemodynamics parameters of special significant form in the cardiac output, the systolic pressure of the pulmonary artery and the telediastolic pressure of the left ventricle, without significantly increasing the consumption of oxygen by the myocardium."( [Levosimendan: a new option in the pharmacologic management of cardiac insufficiency].
Campos Lara, MG; Carballal-Sanjurjo, JC; Del-Razo, OE; Palma-Aguirre, JA, )		1.13
"Levosimendan has an active metabolite, OR-1896."( Levosimendan: a new inodilatory drug for the treatment of decompensated heart failure.
Kivikko, M; Lehtonen, L, 2005)		1.37
"Levosimendan has a more beneficial profile than milrinone regarding the development of ventricular arrhythmias during and after regional myocardial ischemia."( Effect of levosimendan and milrinone on regional myocardial ischemia/reperfusion-induced arrhythmias in dogs.
Papp, JG; Pollesello, P; Varró, AF; Végh, AS, 2006)		1.18
"Levosimendan has a cardioprotective action by inducing coronary vasodilatation and preconditioning by opening KATP channels. "( Effects of levosimendan on myocardial ischaemia-reperfusion injury.
Altunkan, Z; Apa, D; Balli, E; Bilgin, E; Birbicer, H; Doruk, N; Oral, U; Ozeren, M; Tamer, L; Yapici, D, 2008)		1.26
"Levosimendan has a dual mechanism of action: it improves myocardial contractility and causes vasodilatation without increasing myocardial oxygen demand. "( Effects of levosimendan on indocyanine green plasma disappearance rate and the gastric mucosal-arterial pCO2 gradient in abdominal aortic aneurysm surgery.
Leppikangas, H; Lindgren, L; Ruokonen, E; Salenius, JP; Tenhunen, JJ, 2008)		1.26
"Levosimendan has an energetically favorable short-term profile in the treatment of congestive heart failure. "( Myocardial efficiency during levosimendan infusion in congestive heart failure.
Akkila, J; Iida, H; Karanko, M; Knuuti, J; Lehikoinen, P; Lehtonen, L; Någren, K; Saraste, M; Ukkonen, H; Voipio-Pulkki, LM, 2000)		1.15
"Levosimendan increasingly has been used to treat heart failure and cardiac dysfunction in pediatric patients. "( Effect of Levosimendan Treatment in Pediatric Patients With Cardiac Dysfunction: An Update of a Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Belletti, A; Bianzina, S; Momeni, M; Silvetti, S, 2022)		1.64
"Levosimendan has been demonstrated to reduce the incidence of cardiogenic shock and facilitate weaning from cardiopulmonary bypass. "( Short-term effects of levosimendan use for venoarterial extracorporeal membrane oxygenation: A systematic review and meta-analysis.
Guo, B; Li, Y; Yang, B; Zhao, T, 2023)		1.77
"Levosimendan has proven beneficial in improving RV function."( The effect of levosimendan on the right ventricular function in patients with right ventricular dysfunction undergoing mitral valve surgery.
Bharathi, KS; Dhananjaya, M; Pruthi, G; Simha, PP, )		0.95
"Levosimendan has proven to be effective in patients with cardiogenic shock and in those with end-stage heart failure."( Efficacy of levosimendan infusion in patients undergoing a left ventricular assist device implant in a propensity score matched analysis of the EUROMACS registry-the Euro LEVO-LVAD study.
Abdelshafy, M; Berchtold-Herz, M; Caliskan, K; de By, TMMH; Elkoumy, A; Elsherbini, H; Elzomor, H; Gollmann-Tepeköylü, C; Gummert, J; Kimman, JR; Loforte, A; Meyns, B; Mohacsi, P; Paluszkiewicz, L; Reineke, D; Schoenrath, F; Simpkin, AJ; Soliman, O, 2023)		1.74
"Levosimendan has been suggested to reduce mortality of patients with perioperative myocardial dysfunction."( Long-term outcome of perioperative low cardiac output syndrome in cardiac surgery: 1-year results of a multicenter randomized trial.
Abubakirov, MN; Belletti, A; Bianchi, A; Brazzi, L; Calabrò, MG; Crivellari, M; Di Tomasso, N; Fominskiy, EV; Garofalo, E; Grigoryev, EV; Guarracino, F; Landoni, G; Lembo, R; Likhvantsev, VV; Lomivorotov, VV; Monaco, F; Oriani, A; Pasyuga, VV; Paternoster, G; Pisano, A; Scandroglio, AM; Yavorovskiy, A; Zangrillo, A, 2020)		1.04
"Levosimendan has a long-acting metabolite with a half-life of approximately 80 h."( Pre-bypass levosimendan in ventricular dysfunction-effect on right ventricle.
Ahlawat, V; Kumar, D; Kundu, A; Prakash, A; Yadav, A; Yadava, OP, 2021)		1.46
"Levosimendan has salutary effects on right ventricular function in patients with severe left ventricular dysfunction undergoing coronary artery bypass, in terms of improved hemodynamic parameters."( Pre-bypass levosimendan in ventricular dysfunction-effect on right ventricle.
Ahlawat, V; Kumar, D; Kundu, A; Prakash, A; Yadav, A; Yadava, OP, 2021)		1.53
"Levosimendan has shown potential benefits in CA patients."( Levosimendan Ameliorates Post-resuscitation Acute Intestinal Microcirculation Dysfunction Partly Independent of its Effects on Systemic Circulation: A Pilot Study on Cardiac Arrest in a Rat Model.
Jia, T; Liu, G; Lu, X; Luo, C; Shang, Z; Wang, S; Wang, Z; Yang, Q; Zhu, C, 2021)		1.66
"Levosimendan has no benefit in terms of mortality at longest follow up in comparison to dobutamine (Odds ratio 0.77, 95% CI 0.45, 132; p=0.34) and length of ICU stay (MD -4.7days, 95% CI -10.3, 0.9days, p=0.10)."( Levosimendan does not provide mortality benefit over dobutamine in adult patients with septic shock: A meta-analysis of randomized controlled trials.
Baidya, DK; Bhattacharjee, S; Maitra, S; Soni, KD, 2017)		1.49
"Levosimendan has been suggested as a treatment that reduces re-hospitalization and improves quality of life."( Repetitive use of levosimendan in advanced heart failure: need for stronger evidence in a field in dire need of a useful therapy.
Altenberger, J; Baholli, L; Beltrán, P; Borbély, A; Bover, R; Comin-Colet, J; Delgado, JF; Fedele, F; Fontana, A; Fruhwald, F; Garcia-González, MJ; Giamouzis, G; Giannakoulas, G; Gustafsson, F; Kaikkonen, K; Kivikko, M; Kubica, J; Löfman, I; Malfatto, G; Manito, N; Martínez-Sellés, M; Masip, J; Merkely, B; Morandi, F; Mølgaard, H; Oliva, F; Pantev, E; Papp, Z; Perna, GP; Pfister, R; Piazza, V; Pollesello, P; Pölzl, G; Rangel-Sousa, D; Recio-Mayoral, A; Reinecke, A; Rieth, A; Sarapohja, T; Schmidt, G; Seidel, M; Störk, S; von Lewinski, D; Vrtovec, B; Wikström, G; Yerly, P, 2017)		1.25
"Levosimendan has a calcium-sensitizing effect in the myocardium and opens ATP-sensitive potassium channels (K"( Levosimendan prevents bronchoconstriction and adverse respiratory tissue mechanical changes in rabbits.
Babik, B; Balogh, AL; Fodor, GH; Ivankovitsne-Kiss, O; Petak, F; Sudy, R, 2017)		1.57
"Levosimendan has been developed for treatment of severe heart failure. "( Impact of levosimendan on platelet function.
Fabiszak, T; Grześk, G; Kubica, J; Marszałł, MP; Pstrągowski, K; Sikora, A; Sikora, J; Skibińska, N; Sobczak, P, 2017)		1.37
"Levosimendan has vasorelaxant and anti-aggregatory properties."( Cardioprotective and Anti-Aggregatory Effects of Levosimendan on Isoproterenol-Induced Myocardial Injury in High-Fat-Fed Rats Involves Modulation of PI3K/Akt/mTOR Signaling Pathway and Inhibition of Apoptosis: Comparison to Cilostazol.
El-Kherbetawy, MK; Makary, S; Tawfik, MK, 2018)		1.21
"Simendan also has a vasodilatation effect, which causes coronary artery resistance and venous volume blood vessel relax, thereby improving coronary blood supply."( The efficacy of simendan in the treatment of acute heart failure and its impact on NT-proBNP.
Li, J; Li, Y; Wang, XY; Yang, F; Yang, J; Yang, ZY; Yuan, P, 2019)		1.58
"Levosimendan has anti-ischaemic effects, improves myocardial contractility and increases systemic, pulmonary and coronary vasodilatation. "( Effectiveness of prophylactic levosimendan in high-risk valve surgery patients.
Boysan, E; Cicekcioglu, F; Ersoy, O; Katircioglu, F; Unal, EU; Yay, K; Yener, U, 2013)		1.23
"Levosimendan has been extensively used to treat heart failure (HF) for nearly 10 years, but data on levosimendan used in elderly patients with refractory HF remains limited. "( Levosimendan Improves Clinical Outcomes of Refractory Heart Failure in Elderly Chinese Patients.
Huang, J; Qian, J; Yao, Y; Zhang, D, 2015)		1.53
"Levosimendan has been shown to confer direct renoprotection in renal endotoxemic and ischemia-reperfusion injury and could increase renal blood flow in patients with low-cardiac-output heart failure. "( Levosimendan for Prevention of Acute Kidney Injury After Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials.
Chen, D; Gong, J; Liu, B; Liu, M; Wang, W; Zhou, C, 2016)		1.55
"Levosimendan has been studied in different therapeutic settings including acutely decompensated chronic heart failure, advanced heart failure, right ventricular failure, cardiogenic shock, septic shock, and cardiac and non-cardiac surgery."( Levosimendan meta-analyses: Is there a pattern in the effect on mortality?
Harjola, VP; Kivikko, M; Parissis, J; Pollesello, P, 2016)		1.47
"Levosimendan has been seemingly confirmed to reduce mortality in patients undergoing cardiac surgery. "( Levosimendan: new indications and evidence for reduction in perioperative mortality?
Landoni, G; Monti, G; Pisano, A, 2016)		1.55
"Levosimendan has not only improved the cardiac systolic function but also the diastolic relaxation in CHF."( A Review on Role of the Calcium Sensitive Inotropic Agent, Levosimendan and Its Metabolites.
Asif, M, 2018)		1.2
"Levosimendan has a unique dual mechanism of action by enhancing cardiac contractility and causing peripheral vasodilatation. "( Novel biologic mechanisms of levosimendan and its effect on the failing heart.
Andreadou, I; Bistola, V; Filippatos, G; Kremastinos, DT; Paraskevaidis, I; Parissis, JT, 2008)		1.19
"Levosimendan has cardioprotective effects, resulting in reduced postoperative cardiac troponin release."( Levosimendan reduces cardiac troponin release after cardiac surgery: a meta-analysis of randomized controlled studies.
Bignami, E; Biondi-Zoccai, G; Bruno, G; De Santis, V; Gerli, C; Landoni, G; Mizzi, A; Tritapepe, L; Zangrillo, A, 2009)		1.47
"Levosimendan has total clearance 175-250 mL/h/kg and most importantly a short half-life (about 1.5 hours)."( Relationship between the pharmacokinetics of levosimendan and its effects on cardiovascular system.
Antoniades, C; Antonopoulos, AS; Bakogiannis, C; Stefanadi, E; Stefanadis, C; Tousoulis, D, 2009)		1.09
"Levosimendan has cardioprotective effects that could result in a reduced postoperative mortality. "( Reducing mortality in cardiac surgery with levosimendan: a meta-analysis of randomized controlled trials.
Bignami, E; Biondi-Zoccai, G; Bruno, G; Corno, L; Gerli, C; Landoni, G; Mizzi, A; Zambon, M; Zangrillo, A, 2010)		1.18
"Levosimendan has a cardioprotective effect when administered before ischemia in ischemia-reperfusion injury. "( Levosimendan attenuates reperfusion injury in an isolated perfused rat heart model.
Gok, S; Nese, N; Ozturk, T, 2010)		1.48
"Levosimendan has been shown to exert beneficial hemodynamic effects in presence of global myocardial ischemia and heart failure through vasodilatation and increase of cardiac contractility."( Modulation of programmed forms of cell death by intracoronary levosimendan during regional myocardial ischemia in anesthetized pigs.
Caimmi, PP; Cattaneo, M; Grossini, E; Mary, DA; Molinari, C; Platini, F; Tessitore, L; Uberti, F; Vacca, G; Valente, G, 2010)		1.08
"Levosimendan has cardioprotective effects that could result in a reduced mortality in critically ill patients. "( Levosimendan reduces mortality in critically ill patients. A meta-analysis of randomized controlled studies.
Ajello, V; Bignami, E; Biondi-Zoccai, G; Guarracino, F; Landoni, G; Marino, G; Mizzi, A; Prati, P; Zangrillo, A, 2010)		1.48
"Levosimendan has been proposed, in the recent past, to be non-inferior and may have some advantages to standard inotropes; further possible indications for levosimendan have been described, in some observational studies, such as a perioperative use, cardioprotection, cardiogenic shock, sepsis and right ventricular dysfunction."( Levosimendan: from basic science to clinical trials.
Bongo, AS; Lazzero, M; Lupi, A; Rognoni, A; Rognoni, G, 2011)		1.41
"Levosimendan has been reported to exert cardioprotection. "( Intracoronary levosimendan prevents myocardial ischemic damages and activates survival signaling through ATP-sensitive potassium channel and nitric oxide.
Caimmi, PP; Grossini, E; Mary, DA; Micalizzi, E; Molinari, C; Uberti, F; Vacca, G; Valente, G, 2011)		1.26
"Levosimendan has been proposed as an attractive alternative to adrenergic agents for the treatment of sepsis-induced heart failure and haemodynamic derangements. "( No beneficial effects of levosimendan in acute porcine endotoxaemia.
Bendall, J; Chew, MS; Hawthorne, WJ; Huang, S; McLean, A; Simond, D; Ting, I; Whereat, S, 2011)		1.22
"Levosimendan treatment has inotropic, anti-stunning, and cardioprotective effects in the setting of acute decompensated heart failure (HF). "( Value of IGF-I levels in the evaluation of response to treatment with levosimendan in patients with severe heart failure.
Bakır, F; Berker, D; Cetin, M; Çetin, ZG; Ciçekçioğlu, H; Güler, S; Işık, S; Ozuğuz, U; Uçar, O, 2011)		1.16
"Levosimendan has better inotropic and lusitropic effects than epinephrine during rewarming from deep hypothermic circulatory arrest with cardiopulmonary bypass."( Levosimendan is superior to epinephrine in improving myocardial function after cardiopulmonary bypass with deep hypothermic circulatory arrest in rats.
Faggian, G; Linardi, D; Luciani, GB; Mazzucco, A; Menon, T; Rungatscher, A; Tessari, M, 2012)		1.5
"Levosimendan has no significant effect as a phosphodiesterase III inhibitor on in-vitro platelet aggregation in clinically relevant doses."( The inhibitory in-vitro effect of high-dose levosimendan on platelet function may be mediated through its action as a phosphodiesterase inhibitor.
Bent, F; Hofer, S; Kopitz, J; Plaschke, K; Rosenhagen, C; Wagner, S, 2012)		1.19
"Levosimendan has been proposed as a promising drug candidate because of its cardioprotective properties, improved haemodynamic effects in vivo and reduced traumatic brain injury in vitro."( The effects of levosimendan on brain metabolism during initial recovery from global transient ischaemia/hypoxia.
Bleilevens, C; Goetzenich, A; Hein, M; Kipp, M; Kuehn-Velten, N; Roehl, AB; Rossaint, R; Schiefer, J; Tolba, R; Zoremba, N, 2012)		1.19
"Levosimendan also has not been shown to impair ventricular relaxation, which was an initial concern with this class of drugs."( Levosimendan: a unique approach to the treatment of heart failure.
Anderson, JR; Nawarskas, JJ, )		1.17
"Levosimendan has a better profile of security than its predecessors (amrinone and milrinone), improves the haemodynamics parameters of special significant form in the cardiac output, the systolic pressure of the pulmonary artery and the telediastolic pressure of the left ventricle, without significantly increasing the consumption of oxygen by the myocardium."( [Levosimendan: a new option in the pharmacologic management of cardiac insufficiency].
Campos Lara, MG; Carballal-Sanjurjo, JC; Del-Razo, OE; Palma-Aguirre, JA, )		1.13
"Levosimendan has been shown to have beneficial survival effects in several populations; its use improves patient outcomes relative to the standard of care and has the potential to reduce hospital costs associated with heart failure."( Levosimendan: implications for clinicians.
McBride, BF; White, CM, 2003)		1.36
"Levosimendan has an active metabolite, OR-1896."( Levosimendan: a new inodilatory drug for the treatment of decompensated heart failure.
Kivikko, M; Lehtonen, L, 2005)		1.37
"Levosimendan has the potential of improving postresuscitation myocardial function. "( Comparison between dobutamine and levosimendan for management of postresuscitation myocardial dysfunction.
Huang, L; Sun, S; Tang, W; Wang, J; Weil, MH, 2005)		1.16
"Levosimendan has been extensively studied in various animal models of heart failure, in which the drug has increased contractility without adverse effects on diastolic function."( Levosimendan: a calcium-sensitizing agent for the treatment of patients with decompensated heart failure.
Lehtonen, L, 2004)		1.36
"Levosimendan has shown lower mortality compared to dobutamine in patients with acute congestive heart failure."( [Medical and ventilatory treatment of acute heart failure].
Atar, D; Hodt, A; Steine, K, 2006)		0.81
"Levosimendan has a more beneficial profile than milrinone regarding the development of ventricular arrhythmias during and after regional myocardial ischemia."( Effect of levosimendan and milrinone on regional myocardial ischemia/reperfusion-induced arrhythmias in dogs.
Papp, JG; Pollesello, P; Varró, AF; Végh, AS, 2006)		1.18
"Levosimendan has been developed for the treatment of decompensated heart failure and is used intravenously when patients with heart failure require immediate initiation of drug therapy. "( Clinical pharmacology of levosimendan.
Antila, S; Lehtonen, LA; Sundberg, S, 2007)		1.19
"Levosimendan has a cardioprotective action by inducing coronary vasodilatation and preconditioning by opening KATP channels. "( Effects of levosimendan on myocardial ischaemia-reperfusion injury.
Altunkan, Z; Apa, D; Balli, E; Bilgin, E; Birbicer, H; Doruk, N; Oral, U; Ozeren, M; Tamer, L; Yapici, D, 2008)		1.26
"Levosimendan has been used successfully in the treatment of ischaemic cardiac failure and myocardial stunning. "( Levosimendan in acute pulmonary embolism.
Powell, BP; Simes, D, 2007)		1.46
"Levosimendan has inotropic and vasodilatory effects. "( Effects of levosimendan on coronary artery flow and cardiac performance in patients with advanced heart failure.
Bistola, V; Filippatos, G; Ikonomidis, I; Kourea, K; Kremastinos, DT; Lekakis, J; Paraskevaidis, I; Parissis, JT, 2007)		1.25
"Levosimendan has a dual mechanism of action: it improves myocardial contractility and causes vasodilatation without increasing myocardial oxygen demand. "( Effects of levosimendan on indocyanine green plasma disappearance rate and the gastric mucosal-arterial pCO2 gradient in abdominal aortic aneurysm surgery.
Leppikangas, H; Lindgren, L; Ruokonen, E; Salenius, JP; Tenhunen, JJ, 2008)		1.26
"Simendan has favorable and predictable hemodynamic actions. "( Pharmacokinetics and pharmacodynamics of simendan, a novel calcium sensitizer, in healthy volunteers.
Antila, S; Karlsson, M; Lilleberg, J; Nieminen, MS; Pentkäinen, PJ, 1994)		2
"Levosimendan has inotropic and lusitropic actions in failing human myocardium. "( Influence of the novel inotropic agent levosimendan on isometric tension and calcium cycling in failing human myocardium.
Castell, M; Hasenfuss, G; Just, H; Kretschmann, B; Maier, LS; Pieske, B, 1998)		1.12
"Levosimendan has been extensively studied in various animal models of heart failure, in which the drug has increased contractility without adverse effects on diastolic function."( Levosimendan: A promising agent for the treatment of hospitalized patients with decompensated heart failure.
Lehtonen, L, 2000)		1.35
"Levosimendan has an energetically favorable short-term profile in the treatment of congestive heart failure. "( Myocardial efficiency during levosimendan infusion in congestive heart failure.
Akkila, J; Iida, H; Karanko, M; Knuuti, J; Lehikoinen, P; Lehtonen, L; Någren, K; Saraste, M; Ukkonen, H; Voipio-Pulkki, LM, 2000)		1.15
"Levosimendan has shown no clinically important pharmacokinetic interactions with captopril, felodipine, beta-blockers, digoxin, warfarin, isosorbide-5-mononitrate, carvedilol, alcohol (ethanol) or itraconazole."( Levosimendan.
Figgitt, DP; Gillies, PS; Goa, KL, 2001)		1.35
"Levosimendan has been reported to increase cardiac Ca(2+) sensitivity, thereby not enhancing intracellular Ca(2+) or diastolic tension. "( Beneficial effects of the Ca(2+) sensitizer levosimendan in human myocardium.
Brixius, K; Reicke, S; Schwinger, RH, 2002)		1.13

Actions

Levosimendan can increase cardiac ejection function, reduce the heart blood and vascular preload, intrathoracic lung water, improve heart function and systemic hemodynamic indexes of patients with septic shock. The drug has shown lower mortality compared to dobutamine in patients with acute congestive heart failure.

ExcerptReferenceRelevance
"Levosimendan group had lower incidence of atrial fibrillation, shorter length of ICU, and hospital stay."( Comparison of Levosimendan versus Dobutamine in Patients with Moderate to Severe Left Ventricular Dysfunction Undergoing Off-pump Coronary Artery Bypass Grafting: A Randomized Prospective Study.
Ali, MM; Annadurai, M; Kandasamy, A; Murthy, P; Ramanathan, G; Simon, HA, )		0.95
"Levosimendan can increase cardiac ejection function, reduce the heart blood and vascular preload, intrathoracic lung water, improve heart function and systemic hemodynamic indexes of patients with septic shock."( [Effects of levosimendan on hemodynamics and cardiac function in patients with septic shock].
Dong, S; Fang, M, 2014)		1.31
"Levosimendan-induced increase in heart rate possibly facilitated the recovery from bupivacaine intoxication."( The effect of levosimendan on bupivacaine-induced severe myocardial depression in anesthetized pigs.
Aittomäki, J; Heavner, JE; Liuhanen, S; Rosenberg, PH; Sallisalmi, M; Salmenperä, MT, )		0.95
"Levosimendan produced an increase in cΔHbD (p < 0.05) and pΔHbD (NS) and a decrease in heart rate (p < 0.001) and lactate (p < 0.05)."( Acute effects of levosimendan on cerebral and systemic perfusion and oxygenation in newborns: an observational study.
Bravo, MC; Bravo, Mdel C; Cabañas, F; López, P; Pellicer, A; Pérez-Fernández, E; Pérez-Rodríguez, J; Quero, J, 2011)		1.17
"Levosimendan does not increase myocardial oxygen demand and also reduces significantly systemic vascular resistance, pulmonary artery pressure, and pulmonary vascular resistance."( [The novelty in the treatment of heart failure].
Reingardiene, D, 2005)		0.81
"Levosimendan has shown lower mortality compared to dobutamine in patients with acute congestive heart failure."( [Medical and ventilatory treatment of acute heart failure].
Atar, D; Hodt, A; Steine, K, 2006)		0.81
"Levosimendan does not increase markers of oxidative and nitrosative stress in contrast to the placebo treatment, thus, exerting cardioprotective effects in advanced CHF patients. "( Effects of Levosimendan on circulating markers of oxidative and nitrosative stress in patients with advanced heart failure.
Andreadou, I; Bistola, V; Filippatos, G; Iliodromitis, EK; Kremastinos, DT; Louka, A; Markantonis, SL; Paraskevaidis, I; Parissis, JT; Pyriochou, A, 2007)		1.25
"Levosimendan was shown to increase calcium sensitivity by a novel mechanism and to inhibit phosphodiesterase III activity in animal myocardium."( Influence of the novel inotropic agent levosimendan on isometric tension and calcium cycling in failing human myocardium.
Castell, M; Hasenfuss, G; Just, H; Kretschmann, B; Maier, LS; Pieske, B, 1998)		1.12

Treatment

Levosimendan treatment in preterm infants is associated with a rapid improvement of CD and PH, an increase of the mean arterial pressure, and a significant decrease in arterial lactate levels. The drug can be hepatoprotective and it could be useful before extensive liver resection.

ExcerptReferenceRelevance
"Levosimendan treatment in preterm infants is associated with a rapid improvement of CD and PH, an increase of the mean arterial pressure, and a significant decrease in arterial lactate levels, as"( Evaluation of levosimendan as treatment option in a large case-series of preterm infants with cardiac dysfunction and pulmonary hypertension.
Dresbach, T; Geipel, A; Holcher, S; Kipfmueller, F; Leyens, J; Mueller, A; Schroeder, L; Strizek, B, 2023)		1.72
"Levosimendan treatment resulted in a 29.3 m (95% CI: 2.5 to 56.1; p = 0.033) improvement in 6MWD compared with placebo."( Levosimendan Improves Hemodynamics and Exercise Tolerance in PH-HFpEF: Results of the Randomized Placebo-Controlled HELP Trial.
Borlaug, BA; Burkhoff, D; Chung, ES; Lewis, GD; Majure, DT; Mazurek, JA; Preston, IR; Raza, F; Rich, JD; Rich, S; Shah, SJ; Simon, MA; Tedford, RJ; Thenappan, T; Zamanian, RT; Zolty, R, 2021)		1.66
"Levosimendan-treated animals showed significantly higher brain PbtO"( Levosimendan increases brain tissue oxygen levels after cardiopulmonary resuscitation independent of cardiac function and cerebral perfusion.
Dünges, B; García-Bardon, A; Hartmann, EK; Heimann, A; Kamuf, J; Kelm, RF; Krebs, N; Liu, T; Mohr, K; Morsbach, S; Thal, SC; Ziebart, A, 2021)		1.66
"Levosimendan treatment improved cardiac output (VEH vs."( Levosimendan Prevents and Reverts Right Ventricular Failure in Experimental Pulmonary Arterial Hypertension.
Andersen, A; Bogaard, HJ; Hansen, MS; Happé, C; Holmboe, S; Nielsen-Kudsk, JE; Ringgaard, S; Schultz, JG; Simonsen, U, 2017)		1.49
"Levosimendan pretreatment resulted in significant improvement of liver redox homeostasis."( Levosimendan: a cardiovascular drug to prevent liver ischemia-reperfusion injury?
Balla, Z; Fulop, A; Garbaisz, D; Harsanyi, L; Hegedus, V; Lotz, G; Onody, P; Rakonczay, Z; Rosero, O; Stangl, R; Szijarto, A; Turoczi, Z, 2013)		1.43
"Levosimendan pretreatment can be hepatoprotective and it could be useful before extensive liver resection."( Levosimendan: a cardiovascular drug to prevent liver ischemia-reperfusion injury?
Balla, Z; Fulop, A; Garbaisz, D; Harsanyi, L; Hegedus, V; Lotz, G; Onody, P; Rakonczay, Z; Rosero, O; Stangl, R; Szijarto, A; Turoczi, Z, 2013)		1.51
"Levosimendan treatment significantly improved all three systolic parameters."( Long-term levosimendan treatment improves systolic function and myocardial relaxation in mice with cardiomyocyte-specific disruption of the Serca2 gene.
Andersson, KB; Christensen, G; Golz, S; Hillestad, V; Knorr, A; Kramer, F, 2013)		1.23
"Levosimendan treatment was associated with significant changes in hematological variables in patients with ADHF. "( Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure.
Bacaksiz, A; Erdogan, E; Ergelen, M; Erturk, M; Karakurt, H; Sonmez, O; Tasal, A; Turfan, M; Uyarel, H; Vatankulu, MA, 2014)		1.18
"Levosimendan pretreatment (24 h infusion) in patient for OPCABG with poor LVEF shows better outcomes and hemodynamics in terms of inotropes, CPB and IABP requirements. "( Study of levosimendan during off-pump coronary artery bypass grafting in patients with LV dysfunction: a double-blind randomized study.
Brahmbhatt, A; Malhotra, A; Patel, J; Rathod, B; Shah, B; Shah, R; Sharma, P; Shastri, N, )		1.06
"Levosimendan treatment significantly reduced cerebral infarct size in the cortex, but not in the striatal and insular regions."( Insular infarct size but not levosimendan influenced myocardial injury triggered by cerebral ischemia in rats.
Bleilevens, C; Hein, M; Roehl, AB; Rossaint, R; Tolba, R; Zoremba, N, 2015)		1.18
"Levosimendan treatment further reduced adhesion of PMN to activated endothelial cells under both static and flow conditions by approximately 50 %."( Levosimendan exerts anti-inflammatory effects on cardiac myocytes and endothelial cells in vitro.
Aliabadi, A; Buchberger, E; de Martin, R; Demyanets, S; Gröger, M; Hofer-Warbinek, R; Huber, K; Kastl, SP; Kaun, C; Krychtiuk, KA; Maurer, G; Pisoni, J; Rauscher, S; Speidl, WS; Watzke, L; Wojta, J; Zuckermann, A, 2015)		1.46
"Levosimendan-treated patients stayed 1.01 (1.61-0.42) days shorter when compared to control (p = 0.001)."( Levosimendan Reduces Mortality in Adults with Left Ventricular Dysfunction Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis.
Altarabsheh, SE; Avery, EG; Cho, YH; Deo, SV; Hang, D; Lim, JY; Markowitz, AH; McGraw, M; Park, SJ; Rababa'h, A, 2015)		1.46
"Levosimendan alone-treatment concentration-dependently increased phosphorylation of Akt (Ser473)."( Levosimendan inhibits interleukin-1β-induced apoptosis through activation of Akt and inhibition of inducible nitric oxide synthase in rat cardiac fibroblasts.
Okada, M; Yamawaki, H, 2015)		1.46
"Levosimendan treatment prevented deterioration of right ventricular function measured by CI and right ventricular ejection fraction (RVEF) (CI: VEH vs."( Levosimendan Prevents Pressure-Overload-induced Right Ventricular Failure.
Andersen, A; Andersen, S; Hillgaard, TK; Nielsen, JM; Nielsen-Kudsk, JE; Ringgaard, S; Vildbrad, MD, 2016)		1.47
"Levosimendan treatment in patients undergoing surgical revascularization resulted in improved CI, decreased SVR and lower heart rate. "( Comparison of levosimendan and nitroglycerine in patients undergoing coronary artery bypass graft surgery.
Das, A; Hote, M; Malik, V; Sahu, MK; Singh, SP; Subramanian, A, )		1.02
"Levosimendan treated patients had a lower 180-day mortality compared to dobutamine treated (17% vs."( Effect of baseline characteristics on mortality in the SURVIVE trial on the effect of levosimendan vs dobutamine in acute heart failure: Sub-analysis of the Finnish patients.
Harjola, VP; Kivikko, M; Nieminen, MS; Pollesello, P; Sarapohja, T; Tarvasmäki, T, 2016)		1.14
"Levosimendan-treated patients had higher stroke volume index (SVI), cardiac index (CI), LVEF, and left ventricular stroke work index (LVSWI), and lower extravascular lung water index (EVLWI) compared to dobutamine-treated patients (p<0.05)."( Levosimendan Versus Dobutamine in Myocardial Injury Patients with Septic Shock: A Randomized Controlled Trial.
Hu, MH; Ji, CL; Lai, ZZ; Meng, JB; Tian, S; Xu, XJ; Zhang, G, 2016)		1.47
"Levosimendan treatment improved both objective echocardiographic measurements and the subjective QOL questionnaires. "( Assessment of quality of life using three activity questionnaires in heart failure patients after monthly, intermittent administration of levosimendan during a six-month period.
Cokkinos, DV; Dritsas, A; Mavrogeni, SI; Papadopoulou, EF, )		0.89
"Levosimendan treatment significantly improved ventricular function (fractional shortening 0.32 +/- 0.04 vs."( Effects of levosimendan in experimental acute coxsackievirus myocarditis.
Kytö, V; Latva-Hirvelä, J; Levijoki, J; Saraste, A; Saukko, P; Vuorinen, T, 2009)		1.19
"Levosimendan treatment has inotropic, anti-stunning, and cardioprotective effects in the setting of acute decompensated heart failure (HF). "( Value of IGF-I levels in the evaluation of response to treatment with levosimendan in patients with severe heart failure.
Bakır, F; Berker, D; Cetin, M; Çetin, ZG; Ciçekçioğlu, H; Güler, S; Işık, S; Ozuğuz, U; Uçar, O, 2011)		1.16
"Levosimendan treatment improves preimplant hemodynamic performance and permits the identification of patients who will develop right ventricular failure."( Preoperative treatment with levosimendan in candidates for mechanical circulatory support.
Hetzer, R; Ivanitskaia, E; Krabatsch, T; Lehmkuhl, H; Potapov, E; Sponga, S, )		0.9
"Levosimendan treatment resulted in both clinical and echocardiography improvement with the improved EF (42%, 34%, 44%), FS (21%, 16%, 22%) and SV (59, 82, 93 mL/m2)."( [Levosimendan treatment of severe acute congestive heart failure refractory to dobutamine/milrinone in children].
Jovicić, B; Kosutić, J; Nikolić, L; Prijić, S; Rakić, S; Stajević, M; Vukomanović, V, 2011)		1.36
"Levosimendan treatment shows similar effects in heart failure patients with anemia to that of patients without anemia. "( Effects of levosimendan on TNF-alpha, BNP and MMP-1 in patients with heart failure with anemia.
Büyüklü, M; Kürüm, AT; Set, T; Tatlý, E, 2012)		1.29
"Levosimendan treatment was not followed by clinically relevant adverse reactions requiring infusion termination and therapy discontinuation."( [Possibilities of using levosimendan in patients with idiopathic pulmonary hypertension].
Arkhipova, OA; Chazova, IE; Danilov, NM; Kobal', EA; Martyniuk, TV, 2012)		1.15
"Levosimendan treatment improved contractility in post-ischaemic myocardium in patients with PCI-treated STEMI complicated by HF. "( Levosimendan in acute heart failure following primary percutaneous coronary intervention-treated acute ST-elevation myocardial infarction. Results from the LEAF trial: a randomized, placebo-controlled study.
Andersen, GØ; Arnesen, H; Bjørnerheim, R; Eritsland, J; Husebye, T; Mangschau, A; Müller, C; Sandvik, L; Seljeflot, I, 2013)		1.51
"Levosimendan treatment appears to be well-tolerated, with the primary adverse events being headache and hypotension."( Levosimendan: a unique approach to the treatment of heart failure.
Anderson, JR; Nawarskas, JJ, )		1.17
"Levosimendan-treated patients experienced lower risk of death and worsening heart failure than patients receiving placebo, during both the 6h infusion (2.0% vs 5.9%; P=0.033) and over 24h (4.0% vs 8.8%; P=0.044)."( Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN).
Andrejevs, N; Golikov, AP; Kobalava, ZD; Laine, T; Lazebnik, LB; Lehtonen, LA; Lie, KI; Moiseyev, VS; Nieminen, MS; Põder, P; Ruda, MY, 2002)		1.04
"Levosimendan treatment is also associated with significantly improved clinical symptoms."( Randomized clinical trials with levosimendan.
Barraud, D; Mebazaa, A; Welschbillig, S, 2005)		1.08
"Levosimendan pretreatment resulted in a significantly smaller elevation from the preischemic level in left ventricular end-diastolic pressure during reperfusion (37 +/- 17 mm Hg) compared with controls (56 +/- 14 mm Hg) and ischemia-preconditioned hearts (53 +/- 34 mm Hg)."( Preconditioning effects of levosimendan in a rabbit cardiac ischemia-reperfusion model.
Leprán, I; Papp, JG; Pollesello, P; Vajda, S; Varró, A, 2006)		1.1
"Levosimendan treatment offers short-term survival benefit in acute heart failure but its effect on long-term outcome remains unclear."( Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty.
Abreu-González, P; Domínguez-Rodríguez, A; García-González, MJ; Samimi-Fard, S, 2008)		1.18

Toxicity

The most frequent adverse events were increased heart rate, fall, headache and dyspnoea. There were less adverse effects including hypokalemia, hypotension and ventricular premature beats in the levosimendan group than in the dobutamine group. In patients with an acute myocardial infarction the rate of ischemia or hypotension were similar in both groups.

ExcerptReferenceRelevance
" Because these compounds are not yet available for clinical use, the adverse drug events (ADEs) during levosimendan treatment cannot be predicted in detail."( Safety of levosimendan and other calcium sensitizers.
Akkila, J; Lehtonen, L; Mills-Owens, P, 1995)		0.87
" However in patients with an acute myocardial infarction the rate of ischemia or hypotension were similar in levosimendan- and placebo-treated patients and in the dobutamine controlled trials no major adverse effects were seen or they were more frequent in dobutamine patients."( Considerations on the efficacy and safety of levosimendan in ischemic heart failure.
Nieminen, MS; Sandell, EP, 2003)		0.78
"Levosimendan is a safe and efficient choice in the management of low-output syndrome during and after open-heart surgery."( Efficacy and safety of perioperative infusion of levosimendan in patients with compromised cardiac function undergoing open-heart surgery: importance of early use.
Antoniou, T; Degiannis, D; Geroulanos, S; Kriaras, I; Papadopoulos, K; Stavridis, G; Tasouli, A, 2007)		1.15
" The primary combined endpoint of clinical effectiveness (as defined by a eight-variable clinical score) and safety (defined by the absence of serious adverse events) was assessed at 24 hours after the beginning of treatment; a second similar primary combined endpoint was assessed at 5 days."( Effectiveness and safety of levosimendan in clinical practice.
Abreu-Lima, C; Amorim, S; Damasceno, A; Ferreira, J; Ferreira, R; Fonseca, C; Ilídio-Moreira, J; Lousada, N; Martins-de-Campos, J; Oliveira-Soares, A; Rabaçal, C; Seabra-Gomes, R; Silva-Cardoso, J, 2009)		0.64
"In daily practice, levosimendan was clinically effective and safe in 80."( Effectiveness and safety of levosimendan in clinical practice.
Abreu-Lima, C; Amorim, S; Damasceno, A; Ferreira, J; Ferreira, R; Fonseca, C; Ilídio-Moreira, J; Lousada, N; Martins-de-Campos, J; Oliveira-Soares, A; Rabaçal, C; Seabra-Gomes, R; Silva-Cardoso, J, 2009)		0.95
" An ideal inotropic drug should restore effective tissue perfusion by enhancing myocardial contractility without causing adverse effects."( Acute heart failure with low cardiac output: can we develop a short-term inotropic agent that does not increase adverse events?
Campia, U; Gheorghiade, M; Nodari, S, 2010)		0.36
" The incidences of adverse reactions and events were similar between two groups."( [Comparison on efficacy and safety between domestic levosimendan versus dobutamine for patients with acute decompensated heart failure].
Bai, XJ; Huang, Y; Jiang, YN; Li, H; Liu, WX; Qing, EM; Qu, P; Sun, YX; Wei, BQ; Zhang, J; Zhang, L; Zhang, YH; Zhou, Q, 2012)		0.63
" Clinical course of patients, electrocardiogram presentation, LV function, and adverse events at follow-up were recorded."( Safety and feasibility of levosimendan administration in takotsubo cardiomyopathy: a case series.
Brunetti, ND; Carpagnano, G; Di Biase, L; Di Biase, M; Ferraretti, A; Ienco, V; Ieva, R; Lodispoto, M; Santoro, F, 2013)		0.68
" Only 15% of subjects had adverse events during hospital stay; two patients incurred noncardiovascular death at follow-up."( Safety and feasibility of levosimendan administration in takotsubo cardiomyopathy: a case series.
Brunetti, ND; Carpagnano, G; Di Biase, L; Di Biase, M; Ferraretti, A; Ienco, V; Ieva, R; Lodispoto, M; Santoro, F, 2013)		0.68
"The use of levosimendan may be safe and feasible in patients with TTC."( Safety and feasibility of levosimendan administration in takotsubo cardiomyopathy: a case series.
Brunetti, ND; Carpagnano, G; Di Biase, L; Di Biase, M; Ferraretti, A; Ienco, V; Ieva, R; Lodispoto, M; Santoro, F, 2013)		1.03
"Repetitive levosimendan infusions in children with DCM appeared to be hemodynamically well tolerated without severe adverse events."( The Hemodynamic Effects and Safety of Repetitive Levosimendan Infusions on Children With Dilated Cardiomyopathy.
Mattila, N; Nyblom, O; Rahkonen, O; Rautiainen, P; Suominen, P; Turanlahti, M, 2017)		1.06
" Adverse events did not significantly differ between the two groups."( Efficacy and safety of levosimendan in patients with acute right heart failure: A meta-analysis.
Hao, Y; Huang, S; Jia, L; Li, X; Ma, Y; Mao, Y; Qiu, J; Wang, M, 2017)		0.75
" Secondary endpoints included changes in 6-min walk distance (6-MWD), biochemical markers and right heart structure and function together with adverse events on day 7 and incidence of major cardiovascular events (death or readmission due to RHF) on day 30."( Efficacy and safety of a calcium sensitizer, levosimendan, in patients with right heart failure due to pulmonary hypertension.
Gong, SG; He, J; Jiang, R; Liu, JM; Luo, CJ; Qiu, HL; Wang, L; Wu, WH; Yuan, P; Zhang, R; Zhao, QH, 2018)		0.74
" In conclusion, prolonged AI and/or LS infusions in HF are safe and beneficial even in small infants, allowing stabilization and reasonable social and family life out of the hospital."( Ambulatory Intravenous Inotropic Support and or Levosimendan in Pediatric and Congenital Heart Failure: Safety, Survival, Improvement, or Transplantation.
Apostolopoulou, SC; Kakava, F; Rammos, S; Tsoutsinos, A; Vagenakis, GA, 2018)		0.73
" However, side-effects including nephrotoxicity, ototoxicity, gastrointestinal effects and neuropathy restrict the use of the drug due to their adverse impacts on quality of life."( Levosimendan ameliorates cisplatin-induced ototoxicity: Rat model.
Askin, S; Ekinci Akdemir, FN; Eser, G; Gozeler, MS; Sahin, A; Yildirim, S, 2019)		1.07
" Levosimendan is therefore effective and safe in the short-term treatment of chronic systolic heart failure."( Short-term efficacy and safety of levosimendan in patients with chronic systolic heart failure.
Bai, L; Cui, XR; Jia, M; Li, RB; Wang, D; Yang, XH; Zhang, JD, )		0.92
" We select literature according to prespecified inclusion and exclusion criteria and record data such as drug type, mortality, and adverse reactions."( Network Meta-Analysis of the Safety of Drug Therapy for Cardiogenic Shock.
Chen, X; Lei, J; Liao, X; Qian, L; Zhang, S, 2020)		0.56
" Milrinone was most effective at reducing mortality and had the lowest incidence of adverse reactions."( Network Meta-Analysis of the Safety of Drug Therapy for Cardiogenic Shock.
Chen, X; Lei, J; Liao, X; Qian, L; Zhang, S, 2020)		0.56
"This network meta-analysis demonstrated that milrinone was the most effective medication at reducing mortality and adverse events in patients suffering from cardiogenic shock."( Network Meta-Analysis of the Safety of Drug Therapy for Cardiogenic Shock.
Chen, X; Lei, J; Liao, X; Qian, L; Zhang, S, 2020)		0.56
"The use of levosimendan was safe and associated with clinical improvement and reduction in BNP level in AdvHF patients hospitalized due to HF decompensation, although the mortality and re-hospitalization rate during the one-year follow-up remains high."( Multicenter experiences with levosimendan therapy and its safety in patients with decompensated advanced heart failure.
Gruchała, M; Korościk, E; Lelonek, M; Stopczyńska, I; Straburzyńska-Migaj, E, 2020)		1.19
" The most frequent adverse events were increased heart rate (106 [33%] of 326 receiving levosimendan vs 12 [7%] of 166 receiving placebo), fall (85 [26%] vs 48 [29%]), headache (93 [29%] vs 36 [22%]), and dyspnoea (59 [18%] vs 32 [19%])."( Safety and efficacy of oral levosimendan in people with amyotrophic lateral sclerosis (the REFALS study): a randomised, double-blind, placebo-controlled phase 3 trial.
Aho, VV; Al-Chalabi, A; Cudkowicz, M; Garratt, C; Genge, A; Kuoppamäki, M; Maragakis, N; Petri, S; Sarapohja, T; van den Berg, L, 2021)		1.13

Pharmacokinetics

The pharmacokinetic profile of levosimendan in children with congenital heart disease is similar to that in adult patients with congestive heart failure. The aim of this exploratory study was to assess the hemodynamic and Pharmacokinetic interactions between digoxin and oral levosIMendan as well as the proarrhythmic potential.

ExcerptReferenceRelevance
" There were only minor differences between the pharmacokinetic profiles of the enantiomers of simendan."( Pharmacokinetics and pharmacodynamics of simendan, a novel calcium sensitizer, in healthy volunteers.
Antila, S; Karlsson, M; Lilleberg, J; Nieminen, MS; Pentkäinen, PJ, 1994)		0.77
" The pharmacokinetic profile facilitates rapid dose adjustments during intravenous administration."( Pharmacokinetics and pharmacodynamics of simendan, a novel calcium sensitizer, in healthy volunteers.
Antila, S; Karlsson, M; Lilleberg, J; Nieminen, MS; Pentkäinen, PJ, 1994)		0.55
" To observe possible pharmacodynamic interactions psychomotoric tests were made before drug administration and 1h, 2h, 3h and 6h thereafter."( Studies on psychomotoric effects and pharmacokinetic interactions of the new calcium sensitizing drug levosimendan and ethanol.
Akkila, J; Antila, S; Honkanen, T; Järvinen, A; Karlsson, M; Lehtonen, L, 1997)		0.51
" Itraconazole had no significant effects on the pharmacokinetic parameters of levosimendan."( The CYP3A4 inhibitor intraconazole does not affect the pharmacokinetics of a new calcium-sensitizing drug levosimendan.
Antila, S; Honkanen, T; Lehtonen, L; Neuvonen, PJ, 1998)		0.74
" Pharmacokinetic parameters of levosimendan from the third and fourth treatment days were compared with each other."( Pharmacokinetic and pharmacodynamic interactions between the novel calcium sensitiser levosimendan and warfarin.
Antila, S; Honkanen, T; Jarvinen, A; Lehtonen, L, 2000)		0.81
" The distribution volume of warfarin was higher and elimination half-life shorter after concomitant levosimendan administration than after warfarin alone."( Pharmacokinetic and pharmacodynamic interactions between the novel calcium sensitiser levosimendan and warfarin.
Antila, S; Honkanen, T; Jarvinen, A; Lehtonen, L, 2000)		0.74
" The elimination half-life of levosimendan was approximately 1 hour and of the metabolites 70 to 80 hours."( Pharmacodynamics and safety of a new calcium sensitizer, levosimendan, and its metabolites during an extended infusion in patients with severe heart failure.
Antila, S; Eha, J; Kivikko, M; Lehtonen, L; Pentikäinen, PJ, 2002)		0.84
" a one-, two- or three-compartment pharmacokinetic model)."( Population pharmacokinetics of levosimendan in patients with congestive heart failure.
Antila, S; Jonsson, EN; Karlsson, MO; Lehtonen, L; McFadyen, L, 2003)		0.6
"The aim was to study the pharmacodynamic interactions and safety of the co-administration of the calcium sensitizer levosimendan and the calcium antagonist felodipine in patients with coronary heart disease (CHD) and with normal ejection fraction (EF)."( Pharmacodynamic interactions of levosimendan and felodipine in patients with coronary heart disease.
Akkila, J; Antila, S; Eha, J; Heinpalu, M; Lehtonen, L; Loogna, I; Mesikepp, A; Planken, U; Põder, P, )		0.61
"No clinically significant pharmacodynamic interactions between levosimendan and felodipine were seen."( Pharmacodynamic interactions of levosimendan and felodipine in patients with coronary heart disease.
Akkila, J; Antila, S; Eha, J; Heinpalu, M; Lehtonen, L; Loogna, I; Mesikepp, A; Planken, U; Põder, P, )		0.64
"The pharmacokinetic profile of levosimendan in children with congenital heart disease is similar to that in adult patients with congestive heart failure."( Pharmacokinetics of levosimendan in pediatric patients evaluated for cardiac surgery.
Antila, S; Boldt, T; Lehtonen, L; Palkama, T; Pesonen, E; Turanlahti, M, 2004)		0.91
" Pharmacodynamic variables consisted of heart rate-corrected electromechanical systole, heart rate, and systolic and diastolic blood pressure."( Pharmacodynamics and pharmacokinetics of oral levosimendan and its metabolites in patients with severe congestive heart failure: a dosing interval study.
Antila, S; Eha, J; Heinpalu, M; Lehtonen, L; Loogna, I; Planken, U; Põder, P; Rantanen, S; Sundberg, S, 2004)		0.58
"The purpose of this study was to investigate the pharmacokinetics of levosimendan and to determine the primary pharmacokinetic parameters of the pharmacologically active metabolite OR-1896 in rapid and slow acetylators."( Pharmacokinetics of levosimendan and its active metabolite OR-1896 in rapid and slow acetylators.
Antila, S; Lehtonen, L; Nikkanen, H; Pesonen, U; Scheinin, H; Tapanainen, P; Vaahtera, K, 2004)		0.86
"This study was an open-label, nonrandomised, phase I pharmacokinetic study."( Effect of severe renal failure and haemodialysis on the pharmacokinetics of levosimendan and its metabolites.
Häkkinen, S; Harjola, VP; Kantele, S; Kivikko, M; Koskinen, P; Pentikäinen, PJ; Puttonen, J, 2007)		0.57
" In addition, pharmacokinetic parameters of total radiocarbon and the deacetylated congener, OR-1855, were determined."( Pharmacokinetics and excretion balance of OR-1896, a pharmacologically active metabolite of levosimendan, in healthy men.
Häkkinen, S; Koskinen, M; Laine, T; Pentikäinen, P; Pradhan, R; Puttonen, J; Ramela, M; Zhang, W, 2007)		0.56
" The pharmacokinetic parameters were calculated by three-compartmental methods."( Pharmacokinetics and excretion balance of OR-1896, a pharmacologically active metabolite of levosimendan, in healthy men.
Häkkinen, S; Koskinen, M; Laine, T; Pentikäinen, P; Pradhan, R; Puttonen, J; Ramela, M; Zhang, W, 2007)		0.56
" Mean terminal elimination half-life of OR-1896 (t(1/2)) was 70."( Pharmacokinetics and excretion balance of OR-1896, a pharmacologically active metabolite of levosimendan, in healthy men.
Häkkinen, S; Koskinen, M; Laine, T; Pentikäinen, P; Pradhan, R; Puttonen, J; Ramela, M; Zhang, W, 2007)		0.56
" The aim of this exploratory study was to assess the hemodynamic and pharmacokinetic interactions between digoxin and oral levosimendan as well as the proarrhythmic potential of this combination in patients with chronic heart failure."( The hemodynamic and pharmacokinetic interactions between chronic use of oral levosimendan and digoxin in patients with NYHA Classes II-III heart failure.
Harjola, VP; Jurkko, R; Nieminen, MS; Oikarinen, L; Puttonen, J; Sarapohja, T; Sundberg, S; Toivonen, L, 2008)		0.78
" Pharmacokinetic variables of levosimendan and digoxin were calculated in both treatment periods."( The hemodynamic and pharmacokinetic interactions between chronic use of oral levosimendan and digoxin in patients with NYHA Classes II-III heart failure.
Harjola, VP; Jurkko, R; Nieminen, MS; Oikarinen, L; Puttonen, J; Sarapohja, T; Sundberg, S; Toivonen, L, 2008)		0.85
" In contrast to the earlier data with intravenous levosimendan, the results indicate a pharmacokinetic interaction between levosimendan and digoxin."( The hemodynamic and pharmacokinetic interactions between chronic use of oral levosimendan and digoxin in patients with NYHA Classes II-III heart failure.
Harjola, VP; Jurkko, R; Nieminen, MS; Oikarinen, L; Puttonen, J; Sarapohja, T; Sundberg, S; Toivonen, L, 2008)		0.82
" A two compartment pharmacokinetic model with zero-order input and first-order elimination has been found to describe best the pharmacokinetics of levosimendan."( Relationship between the pharmacokinetics of levosimendan and its effects on cardiovascular system.
Antoniades, C; Antonopoulos, AS; Bakogiannis, C; Stefanadi, E; Stefanadis, C; Tousoulis, D, 2009)		0.81
" After a 24-hour infusion of levosimendan, the pharmacodynamic effect of the drug is observed for at least one week."( The importance of pharmacokinetics, pharmacodynamic and repetitive use of levosimendan.
Banach, J; Dobosiewicz, M; Gilewski, W; Grześk, G; Hertmanowski, W; Kowalkowska, M; Rogowicz, D; Wołowiec, Ł, 2022)		1.23
" In light of LVSMD pharmacological characteristics, we hypothesized that ECMO may induce major pharmacokinetic (PK) modifications for LVSMD and its metabolites."( Population Pharmacokinetics of Levosimendan and its Metabolites in Critically Ill Neonates and Children Supported or Not by Extracorporeal Membrane Oxygenation.
Berthomieu, L; Bourgoin, P; Chenouard, A; Davril, E; Duflot, T; Joram, N; Lamoureux, F; Lecomte, J; Oualha, M; Pereira, T, 2023)		1.19

Compound-Compound Interactions

Levosimendan, a calcium sensitizer, was used in combination with beta-adrenergic antagonists in a man aged 56 yr with cardiogenic shock, complicating acute myocardial infarction. The patient developed severe tachycardia after dobutamine administration. Increasing evidence suggests the use of levosim endan in combination to treat decompensated heart failure that is refractory to dobutamines alone.

ExcerptReferenceRelevance
"Levosimendan, a calcium sensitizer, was used in combination with beta-adrenergic antagonists in a man aged 56 yr with cardiogenic shock, complicating acute myocardial infarction, who developed severe tachycardia after dobutamine administration."( Treatment of cardiogenic shock with levosimendan in combination with beta-adrenergic antagonists.
Alhashemi, JA, 2005)		1.15
" Increasing evidence suggests the use of levosimendan in combination with dobutamine in patients with decompensated heart failure that is refractory to dobutamine alone."( The use of levosimendan in comparison and in combination with dobutamine in the treatment of decompensated heart failure.
Cavusoglu, Y, 2007)		0.95
" We examined whether intermittent inotropic agents combined with oral amiodarone to prevent the proarrhythmic effect of inotropic agents results in better outcomes."( Intermittent inotropic infusions combined with prophylactic oral amiodarone for patients with decompensated end-stage heart failure.
Bonios, M; Drakos, SG; Kaldara, E; Kanakakis, JV; Katsaros, F; Nanas, JN; Nanas, S; Pantsios, C, 2009)		0.35
"Intermittent intravenous inotropic agents combined with prophylactic oral amiodarone seem to improve the outcomes of patients with end-stage chronic heart failure."( Intermittent inotropic infusions combined with prophylactic oral amiodarone for patients with decompensated end-stage heart failure.
Bonios, M; Drakos, SG; Kaldara, E; Kanakakis, JV; Katsaros, F; Nanas, JN; Nanas, S; Pantsios, C, 2009)		0.35
"Levosimendan combined with epinephrine may be superior to either drug alone for lipid-based resuscitation in a rat model of bupivacaine-induced cardiac arrest."( Levosimendan combined with epinephrine improves rescue outcomes in a rat model of lipid-based resuscitation from bupivacaine-induced cardiac arrest.
Cai, X; Chen, L; Li, M; Li, Z; Nan, F; Xu, X; Ye, Y, 2017)		1.57
"To investigate the clinical effects of Xinkeshu combined with levosimendan on perioperative heart failure in oldest-old patients with hip fractures."( Effects of Xinkeshu combined with levosimendan on perioperative heart failure in oldest-old patients with hip fractures.
Fu, M; Liu, Y; Wang, Z, 2020)		1.07
" Clinical manifestations; left ventricular ejection fraction (LVEF); left ventricular end-diastolic dimension (LVEDD); left ventricular end-systolic dimension (LVESD); B-type natriuretic peptide (BNP), superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO), and endothelin-1 (ET-1) levels; and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were compared between before and after treatment to evaluate the curative effects of Xinkeshu combined with levosimendan."( Effects of Xinkeshu combined with levosimendan on perioperative heart failure in oldest-old patients with hip fractures.
Fu, M; Liu, Y; Wang, Z, 2020)		0.99
"Levosimendan combined with Xinkeshu can improve cardiac function, alleviate oxidative stress, and relieve anxiety and depression in oldest-old patients with perioperative heart failure and hip fracture."( Effects of Xinkeshu combined with levosimendan on perioperative heart failure in oldest-old patients with hip fractures.
Fu, M; Liu, Y; Wang, Z, 2020)		1.39
" The aim of this study was to investigate efficacy of levosimendan when combined with rhBNP in patients with diuretic resistance and low ejection fraction (EF) rate."( Effect of levosimendan combined with recombinant human brain natriuretic peptide on diuretic resistance.
Jun, M; Lan, L; Libiya, Z; Shubin, J; Xiangli, S, 2021)		1.23

Bioavailability

Oral levosimendan has high bioavailability (approximately equal to 85%). In clinical practice it has been hitherto administered intravenously. Site specific bioavailability and metabolism of levosicendan was studied in ten dogs by placing intestinal access port catheters.

ExcerptReferenceRelevance
" The bioavailability of oral levosimendan was 85 +/- 6% in healthy volunteers and 84 +/- 4% in patients."( Pharmacokinetics of levosimendan in healthy volunteers and patients with congestive heart failure.
Antila, S; Hayha, M; Heikkinen, P; Lehtonen, LA; Ottoila, P; Pentikainen, PJ; Sandell, EP, 1995)		0.88
" The bioavailability of CT and CC was 83 and 87%, while that of SR was only 31%."( Integrated pharmacokinetics and pharmacodynamics of the novel calcium sensitizer levosimendan as assessed by systolic time intervals.
Antila, S; Häyhä, M; Lehtonen, L; Scheinin, H; Sundberg, S; Virtanen, M, 1998)		0.52
"Site specific bioavailability and metabolism of levosimendan was studied in ten dogs by placing intestinal access port catheters in different parts of the gastrointestinal tract."( Site dependent bioavailability and metabolism of levosimendan in dogs.
Antila, S; Huuskonen, H; Kanerva, H; Lehtonen, L; Nevalainen, T; Vanninen, P, 1999)		0.8
"The aim of this study was to investigate the possibility of developing different levels of correlation between in vitro release and in vivo absorption rate for four modified-release levosimendan capsule formulations."( Development of level A, B and C in vitro-in vivo correlations for modified-release levosimendan capsules.
Antila, S; Bäckman, M; Kortejärvi, H; Marvola, M; Mikkola, J, 2002)		0.73
" Three bioavailability studies of levosimendan were used to develop IVIVC model."( Level A in vitro-in vivo correlation (IVIVC) model with Bayesian approach to formulation series.
Kortejärvi, H; Malkki, J; Marvola, M; Pajunen, P; Urtti, A; Yliperttula, M, 2006)		0.6
" Although oral levosimendan has high bioavailability (approximately equal to 85%), in clinical practice it has been hitherto administered intravenously."( Relationship between the pharmacokinetics of levosimendan and its effects on cardiovascular system.
Antoniades, C; Antonopoulos, AS; Bakogiannis, C; Stefanadi, E; Stefanadis, C; Tousoulis, D, 2009)		0.94

Dosage Studied

Levosimendan was associated with an increased risk of adverse cardiovascular events. A suitably powered randomised controlled trial is required to confirm these findings and to address the unresolved questions about the timing and dosing of levosim endan.

ExcerptRelevanceReference
"0 mg to define its safety and dose-response effects."( Hemodynamic effects of the novel cardiotonic drug simendan: echocardiographic assessment in healthy volunteers.
Leikola-Pelho, T; Lilleberg, JM; Nieminen, MS; Sundberg, S, 1994)		0.54
" A dose-response relationship was demonstrated for levosimendan on increases in CO and SV, and reductions in PCWP during the infusion (for all, p< or =0."( Hemodynamic and neurohumoral effects of continuous infusion of levosimendan in patients with congestive heart failure.
Akkila, J; Hasenfuss, G; Kleber, FX; Lehtonen, LA; Mitrovic, V; Nieminen, MS; Nyquist, O; Remme, WJ, 2000)		0.79
" A sensitivity analysis on dosage of drug and duration of survival was performed."( Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial.
Apajasalo, M; Cleland, JG; Kobelt, G; Takala, A; Zethraeus, N, 2003)		0.66
" Dobutamine was continuously infused at a dosage of 3 microg kg(-1) min(-1)."( Levosimendan improves postresuscitation outcomes in a rat model of CPR.
Cammarata, G; Cao, L; Huang, L; Sun, S; Tang, W; Weil, MH, 2005)		0.89
" More data are needed regarding patient selection and the optimum regimen and dosing of levosimendan before this treatment modality become the first line therapy of acutely decompensated chronic heart failure patients."( Classical inotropes and new cardiac enhancers.
Farmakis, D; Nieminen, M; Parissis, JT, 2007)		0.56
" We investigate the proper time for its infusion during or after open-heart surgery to avoid complications related with low-output syndrome and high dosage of inotropes."( Efficacy and safety of perioperative infusion of levosimendan in patients with compromised cardiac function undergoing open-heart surgery: importance of early use.
Antoniou, T; Degiannis, D; Geroulanos, S; Kriaras, I; Papadopoulos, K; Stavridis, G; Tasouli, A, 2007)		0.59
" We assessed the dose-response relationship of oral LS in nine normal and seven pacing-induced heart failure (HF), conscious, chronically instrumented mongrel dogs."( Orally available levosimendan dose-related positive inotropic and lusitropic effect in conscious chronically instrumented normal and heart failure dogs.
Cheng, CP; Cheng, HJ; Heikkilä, A; Hyttilä-Hopponen, M; Levijoki, J; Little, WC; Masutani, S; Vuorela, A, 2008)		0.66
" The mean dosing interval was 66."( Repeated infusions of levosimendan: well tolerated and improves functional capacity in decompensated heart failure - a single-centre experience.
Best, M; Dembo, L; Driscoll, GO; Parle, NM; Thomas, MD, 2008)		0.65
" However, because the maximum duration of levosimendan infusion is 24 hours, dosing adjustments of levosimendan may not be required in subjects with impaired hepatic function."( Pharmacokinetics of intravenous levosimendan and its metabolites in subjects with hepatic impairment.
Häkkinen, S; Kantele, S; Kivikko, M; Pentikäinen, PJ; Puttonen, J; Ramela, M; Ruck, A, 2008)		0.88
" Five patients presenting with reduced ejection fraction (EF<30%) and high dosed catecholamines after heart transplantation were treated with levosimendan (Simdax, Abbot GesmbH, Vienna, Austria) in a 24-hour continuous infusion (0."( Primary graft failure and Ca2+ sensitizers after heart transplantation.
Beiras-Fernandez, A; Kaczmarek, I; Kur, F; Reichart, B; Schmoeckel, M; Weis, FC; Weis, M, 2008)		0.55
" The frequency and dosing of inotropic infusions in patients admitted with acute heart failure was assessed in detail."( The use of more than one inotrope in acute heart failure is associated with increased mortality: a multi-centre observational study.
Harjola, VP; Lassus, J; Melin, J; Nieminen, MS; Peuhkurinen, K; Rossinen, J; Siirila-Waris, K, 2008)		0.35
" A suitably powered randomised controlled trial is required to confirm these findings and to address the unresolved questions about the timing and dosing of levosimendan."( Levosimendan and mortality after coronary revascularisation: a meta-analysis of randomised controlled trials.
Maharaj, R; Metaxa, V, 2011)		1.12
"To assess the effect of various levosimendan dosing regimens on hemodynamics in a rodent model of propranolol poisoning."( Levosimendan does not improve cardiac output or blood pressure in a rodent model of propranolol toxicity when administered using various dosing regimens.
Graudins, A; Kalam, Y, 2012)		1.21
" Levosimendan did not improve CO or BP with any dosing regimen."( Levosimendan does not improve cardiac output or blood pressure in a rodent model of propranolol toxicity when administered using various dosing regimens.
Graudins, A; Kalam, Y, 2012)		1.45
" Anemia is a deteriorating situation that causes increase of drug dosing in patients with heart failure."( Effects of levosimendan on TNF-alpha, BNP and MMP-1 in patients with heart failure with anemia.
Büyüklü, M; Kürüm, AT; Set, T; Tatlý, E, 2012)		0.73
" LEVO may have advantages over MR in terms of the dosing regimen."( Phase 1 study of two inodilators in neonates undergoing cardiovascular surgery.
Bravo, MC; Buño, A; Cabañas, F; Castro, L; Labrandero, C; Lopez-Ortego, P; Lubomirov, R; Madero, R; Pellicer, A; Perez-Rodriguez, J; Quero, J; Riera, J, 2013)		0.39
" As dosed in this trial, levosimendan was associated with an increased risk of adverse cardiovascular events."( Effect of levosimendan on the short-term clinical course of patients with acutely decompensated heart failure.
Colucci, W; Delgado-Herrera, L; Fisher, L; Garratt, C; Huang, B; Massie, BM; Packer, M; Padley, RJ; Salon, J; Sarapohja, T; Teerlink, JR; Thakkar, R; Young, J, 2013)		1.04
" The panel gave recommendations regarding patient dosing and monitoring, derived from the available evidence and from clinical experience."( Repetitive use of levosimendan for treatment of chronic advanced heart failure: clinical evidence, practical considerations, and perspectives: an expert panel consensus.
Altenberger, J; Ben-Gal, T; Böhmer, A; Comin-Colet, J; Dickstein, K; Edes, I; Fedele, F; Fonseca, C; García-González, MJ; Giannakoulas, G; Iakobishvili, Z; Jääskeläinen, P; Karavidas, A; Kettner, J; Kivikko, M; Lund, LH; Matskeplishvili, ST; Metra, M; Morandi, F; Nieminen, MS; Oliva, F; Parissis, J; Parkhomenko, A; Pollesello, P; Pölzl, G; Schwinger, RH; Segovia, J; Seidel, M; Vrtovec, B; Wikström, G, 2014)		0.72
" Further studies are needed to focus on morbidity and mortality outcomes, dosing intervals, and patient monitoring."( Repetitive use of levosimendan for treatment of chronic advanced heart failure: clinical evidence, practical considerations, and perspectives: an expert panel consensus.
Altenberger, J; Ben-Gal, T; Böhmer, A; Comin-Colet, J; Dickstein, K; Edes, I; Fedele, F; Fonseca, C; García-González, MJ; Giannakoulas, G; Iakobishvili, Z; Jääskeläinen, P; Karavidas, A; Kettner, J; Kivikko, M; Lund, LH; Matskeplishvili, ST; Metra, M; Morandi, F; Nieminen, MS; Oliva, F; Parissis, J; Parkhomenko, A; Pollesello, P; Pölzl, G; Schwinger, RH; Segovia, J; Seidel, M; Vrtovec, B; Wikström, G, 2014)		0.72
" Our aim was to compare acute dose-response hemodynamic effects of inodilators dobutamine (DOB), milrinone (MIL), and levosimendan (LEV) in chronic experimental PH."( Dose-Response Head-to-Head Comparison of Inodilators Dobutamine, Milrinone, and Levosimendan in Chronic Experimental Pulmonary Hypertension.
Alaa, M; Leite, S; Leite-Moreira, AF; Lopes, L; Lourenço, AP; Oliveira-Pinto, J; Tavares-Silva, M, 2017)		0.89
"Based on these data it can be assumed that the use of prolonged infusion of levosimendan in a dosage of 12."( [A COMPARISON OF TWO APPROACHES FOR INTRAOPERATIVE LEVOSIMENDAN ADMINISTRATION IN CARDIAC SURGICAL PATIENTS WITH SEVERE LEFT VENTRICLE DYSFUNCTION.]
Adzhigaliev, RR; Belov, SI; Berezhnoy, SA; Panov, OS; Pasyuga, VV; Tarasov, DG; Yavorovsky, AG; Yusupova, ES, 2016)		0.91
" The cumulative dosage of levosimendan was recorded to assess the required dosage in the context of individualized treatment."( [Individualized use of levosimendan in cardiac surgery].
Dashkevich, A; Juchem, G; Kilger, E; Mehringer, L; Schünemann, M; Weis, M; Woehrle, T, 2021)		1.21
"2% of patients, a cumulative dosage of 5 mg levosimendan or less was considered sufficient."( [Individualized use of levosimendan in cardiac surgery].
Dashkevich, A; Juchem, G; Kilger, E; Mehringer, L; Schünemann, M; Weis, M; Woehrle, T, 2021)		1.17
"25 mg levosimendan followed by individualized additional dosing in cardiac surgery patients with preoperative LVEF ≤40% suggests that this concept is safe, with possible advantages regarding the need of inotropic agents, renal replacement therapy, and 30-day mortality, compared to the current literature."( [Individualized use of levosimendan in cardiac surgery].
Dashkevich, A; Juchem, G; Kilger, E; Mehringer, L; Schünemann, M; Weis, M; Woehrle, T, 2021)		1.32
" The dosage and administration time of dopamine and epinephrine, mechanical ventilation time, ICU length of stay, and postoperative adverse events were recorded."( Prospective Study on the Postoperative Use of Levosimendan After Conventional Heart Valve Replacement.
Li, H; Lv, X; Niu, Z; Qiao, H; Sheng, W; Wang, T; Wu, J; Zhang, W, 2021)		0.87
" The purpose of this review is to discuss clinical controversies in the management of septic patients, including the use of novel medications and dosing strategies, to assist providers in appropriately determining what treatment strategy is best suited for patients."( Beyond the bundle: Clinical controversies in the management of sepsis in emergency medicine patients.
Bonderski, V; Krishnan, K; Rech, MA; Tednes, P; Wassermann, TB, 2022)		0.72
" Levosimendan dosing varied considerably with only three studies using a loading dose."( Levosimendan in paediatric cardiac anaesthesiology: A systematic review and meta-analysis.
Lapere, M; Rega, F; Rex, S, 2022)		1.79
" Simulated data revealed that standard dosing may not be appropriate for patients under ECMO, with a decrease in the steady-state concentration of LVSMD and lower exposure to the active metabolite OR-1896."( Population Pharmacokinetics of Levosimendan and its Metabolites in Critically Ill Neonates and Children Supported or Not by Extracorporeal Membrane Oxygenation.
Berthomieu, L; Bourgoin, P; Chenouard, A; Davril, E; Duflot, T; Joram, N; Lamoureux, F; Lecomte, J; Oualha, M; Pereira, T, 2023)		1.19
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (1,240)

TimeframeStudies, This Drug (%)All Drugs %
pre-19900 (0.00)18.7374
1990's53 (4.27)18.2507
2000's472 (38.06)29.6817
2010's534 (43.06)24.3611
2020's181 (14.60)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 27.60

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be moderate demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index27.60 (24.57)
Research Supply Index7.35 (2.92)
Research Growth Index5.29 (4.65)
Search Engine Demand Index39.34 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (27.60)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials255 (19.54%)5.53%
Reviews263 (20.15%)6.00%
Case Studies114 (8.74%)4.05%
Observational13 (1.00%)0.25%
Other660 (50.57%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (91)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
The Effects of Levosimendan on Haemodynamics in Patients Undergoing Elective Aortic Valve Replacement (AVR)Together With Coronary Artery Bypass Grafting [NCT01210976]Phase 424 participants (Actual)Interventional2009-01-31Completed
Perioperative Levosimendan Administration in Neonates With Transposition of the Great Arteries: Randomized Controlled Trial [NCT01120106]Phase 263 participants (Actual)Interventional2009-01-31Completed
Preoperative Optimization of the High-Risk Patient Undergoing Hip Fracture Surgery [NCT01219712]200 participants (Anticipated)Interventional2011-01-31Not yet recruiting
Inotropic Treatment With Levosimendan (SimdaxR)in Heart Surgery [NCT01221116]23 participants (Actual)Interventional2003-01-31Terminated(stopped due to The study was stopped due to difficulties in including patients)
Early Use of Levosimendan Compared to Usual Care in Advanced Chronic Heart Failure (ACHF) [NCT01290146]Phase 313 participants (Actual)Interventional2011-02-28Terminated(stopped due to Due to lack of enrollment)
Effects of Oral Levosimendan (ODM-109) on Respiratory Function in Patients With ALS: Open-Label Extension for Patients Completing Study 3119002 [NCT03948178]Phase 3227 participants (Actual)Interventional2019-06-26Terminated(stopped due to This was an open label extension for patients completing the REFALS study (3119002; NCT03505021). Study 3119002 showed lack of efficacy of ODM109 so the sponsor decided to terminate this study)
Open-Label Rollover Study of Levosimendan in Patients With Pulmonary Hypertension With Heart Failure and Preserved Left Ventricular Ejection Fraction (PH-HFpEF) [NCT03624010]Phase 236 participants (Anticipated)Interventional2018-11-14Active, not recruiting
Levosimendan Versus Milrinone to Support Hemodynamics During Off Pump Coronary Artery Bypass Grafting Surgery in Patients With Poor Ejection Fraction [NCT03855579]Phase 460 participants (Anticipated)Interventional2019-03-06Recruiting
Phase II Study to Evaluate the Efficacy and Safety of Levosimendan in Severe Acute Heart Failure in Critical Children [NCT01301313]Phase 2116 participants (Actual)Interventional2011-02-28Terminated
Effects of Levosimendan in Acute Kidney Injury After Cardiac Surgery [NCT02531724]Phase 430 participants (Actual)Interventional2015-09-30Completed
Effectiveness of a Repetitive Use of 24-hour Levosimendan Infusions in Patients With Severe Systolic Heart Failure in Order to Prevent Rehospitalizations [NCT03764722]Phase 4100 participants (Anticipated)Interventional2018-08-01Recruiting
Pilot Study on the Effects of Levosimendan on in Vivo Respiratory Muscle Function in Healthy Subjects [NCT01101620]30 participants (Actual)Interventional2010-04-30Completed
Effects of Levosimendan Pretreatment in Patients With Low Ejection Fraction (40 % or Less) Undergoing CABG: a Randomised, Double Blind, Multicenter Trial [NCT02184819]Phase 3335 participants (Actual)Interventional2013-06-30Completed
The Prophylactic Effect of Levosimendan in Reducting Acute Kidney Injury Postoperatively in Pediatric Patients Undergoing Corrective Heart Surgery [NCT02232399]Phase 272 participants (Actual)Interventional2014-10-31Completed
Ensayo clínico, Fase III, Aleatorizado, Prospectivo, unicéntrico, Doble Ciego y Controlado Con Placebo, Para Estimar la Eficacia y Seguridad Del Levosimendan Intravenoso, en Las Primeras 24 Horas Tras la Angioplastia Primaria, en Pacientes Con síndrome Co [NCT03699215]Phase 3184 participants (Anticipated)Interventional2018-11-17Recruiting
Pretreatment With Levosimendan In Patients Undergoing Left Ventricular Assist Device Implantation [NCT03659851]50 participants (Anticipated)Observational [Patient Registry]2009-06-01Recruiting
A Randomized Controlled Clinical Study of Early Application of Levosimendan to Improve Cardiac Dysfunction and Neurological Prognosis in Patients With Cardiac Arrest [NCT05956431]Phase 460 participants (Anticipated)Interventional2023-08-01Not yet recruiting
Efficacy of Intravenous Levosimendan Compared With Dobutamine on Renal Hemodynamics and Function in Chronic Heart Failure [NCT02133105]Phase 333 participants (Actual)Interventional2014-04-30Completed
Prophylactic Administration of Levosimendan in Patients With Impaired Left Ventricular Function Undergoing Coronary Surgery [NCT01318460]Phase 432 participants (Actual)Interventional2011-03-31Completed
Effects of Oral Levosimendan on Ambulatory Electrocardiographic Variables and Cerebrovascular Reactivity in Patients With Recent Stroke or TIA. [NCT00698763]Phase 232 participants (Actual)Interventional2008-08-31Completed
Effect of Levosimendan or Placebo on Exercise Capacity and Hemodynamics in Patients With Advanced Chronic Heart Failure (LOCO-CHF Trial) [NCT03576677]Phase 442 participants (Anticipated)Interventional2019-08-01Recruiting
The Role of Preoperative Use of Levosimendan in Ischemic Cardiac Patients Undergoing Major Abdominal Cancer Surgeries: A Prospective Randomized Study [NCT03557255]Phase 260 participants (Actual)Interventional2017-08-01Completed
A Double-Blind, Randomized, Placebo-Controlled Study of Levosimendan in Pulmonary Hypertension Patients With Heart Failure and Preserved Left Ventricular Ejection Fraction (PH-HFpEF) [NCT03541603]Phase 238 participants (Actual)Interventional2018-11-14Completed
Effects of Oral Levosimendan (ODM-109) on Respiratory Function in Patients With ALS [NCT03505021]Phase 3496 participants (Actual)Interventional2018-06-21Completed
Double-blind Randomized Placebo-controlled Study to Evaluate the Efficacy and Safety of Intermittent, Long-term Administration of Levosimendan in Patients With Advanced Heart Failure [NCT00988806]Phase 4213 participants (Anticipated)Interventional2009-11-30Enrolling by invitation
Platform Adaptive Embedded Trial for Acute Respiratory Distress Syndrome [NCT05658692]Phase 41,000 participants (Anticipated)Interventional2022-10-01Recruiting
Potential Differences Between Levosimendan and Milrinone on Myocardial and Hemodynamic Variables in Patients With Septic Cardiomyopathy. Effects of Norepinephrine on Right Ventricular Function in Patient With Septic Shock. [NCT02640846]Phase 430 participants (Actual)Interventional2015-12-31Active, not recruiting
Use of Levosimendan as Treatment of Aneurysmal SubArachnoid Hemorrhage [NCT05664191]Phase 230 participants (Anticipated)Interventional2023-03-01Not yet recruiting
A Clinical Study on Levosimendan Improvement of Prognosis of ARDS Patients by Optimizing Pulmonary Hemodynamics [NCT04020003]Phase 3120 participants (Anticipated)Interventional2019-07-01Recruiting
Preoperative Levosimendan in Patients With Heart Failure Undergoing Elective Noncardiac Surgery: A Randomized, Placebocontrolled Trial. SIMPLE Study [NCT01022983]Phase 40 participants (Actual)Interventional2011-04-30Withdrawn(stopped due to Not finding patients for including)
LEVOSIMENDAN to Facilitate Weaning From ECMO in Severe Cardiogenic Shock Patients [NCT04728932]Phase 3206 participants (Anticipated)Interventional2021-08-27Recruiting
[NCT00695929]50 participants (Anticipated)Interventional2008-07-31Completed
Phase 2 Prospective, Randomized, Double-Blind Pilot Study on Cardiac Output Following Corrective Open Heart Surgery in Children Less Than One Year: Use of Levosimendan Versus Milrinone. [NCT00549107]Phase 240 participants (Anticipated)Interventional2007-09-30Recruiting
Levosimendan Pre-Treatment in Patients Undergoing Coronary Artery Bypass Graft Surgery: a Double-Blind, Single Center, Prospective, Randomized, Placebo-Controlled Trial [NCT00610350]Phase 4100 participants (Actual)Interventional2005-01-31Completed
Renal Effects of Levosimendan in Patients Admitted With Acute Decompensated Heart Failure [NCT00527059]Phase 421 participants (Anticipated)Interventional2007-10-31Not yet recruiting
Levosimendan and Inhaled Nitric Oxide for Resuscitating the Microcirculation in Septic Shock. A Randomized Controlled Trial [NCT00800306]Phase 240 participants (Actual)Interventional2007-11-30Completed
Efficacy of Levosimendan in Cardiac Failure After Heart Valve Surgery [NCT00154115]Phase 4200 participants (Anticipated)Interventional2005-03-31Completed
Efficacy and Safety of Pulsed Infusions of Levosimendan in Outpatients With Advanced Heart Failure - A Multicenter, Double-blind, Placebo Controlled Prospective Trial With Two Arms [NCT01065194]Phase 3120 participants (Anticipated)Interventional2009-08-31Recruiting
The Effects of Levosimendan on Renal Function in Patients With Low Ejection Fraction Undergoing Mitral Valve Surgery. [NCT01969071]Phase 4140 participants (Actual)Interventional2009-07-31Completed
[NCT02012946]Phase 440 participants (Anticipated)Interventional2013-12-31Not yet recruiting
A Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Effectiveness and Safety of Levosimendan in Patients With Severe Aortic Stenosis and Heart Failure Undergoing Transcatheter Aortic Valve Replacement [NCT04573049]Phase 4124 participants (Anticipated)Interventional2020-09-01Recruiting
Levosimendan to Reduce Mortality in High Risk Cardiac Surgery Patients. A Multicentre Randomized Controlled Trial [NCT00994825]Phase 41,000 participants (Anticipated)Interventional2009-11-30Completed
Interest of Levosimendan in Reducing Weaning Failures of ExtraCorporeal Life Support - ECLS. Randomized, Controlled, Multicenter, Double-blind, Multicenter Clinical Trial [NCT04158674]Phase 3210 participants (Anticipated)Interventional2020-02-24Recruiting
Rationale and Design of a Multicenter Randomized Trial of Levosimendan to Reduce Low Cardiac Output Syndrome in Low Ejection Fraction (≤ 35%) Cardiac Surgery Patients. Spanish Randomized Clinical Trial on Levosimendan (SPARTANS Study) [NCT04179604]Phase 2/Phase 3300 participants (Anticipated)Interventional2020-06-17Recruiting
Multicenter, Double-blind, Placebo-controlled Randomized Trial to Evaluate the Efficacy and Safety of Intravenous Administration of Intermittent Doses of Levosimendan in Ambulatory Patients With Advanced CHF: the LION-HEART Study [NCT01536132]Phase 470 participants (Actual)Interventional2010-04-30Completed
Effects of Levosimendan on Cellular Metabolic Alterations in Patients With Septic Shock: A Randomised Controlled Study [NCT02963454]50 participants (Anticipated)Interventional2011-01-31Recruiting
Efficacy of Levosimendan in the Critically Ill Patients With Unstable Hemodynamics (the LICI Study) - A Double Blind Randomized Pilot Study [NCT00093301]Phase 2/Phase 340 participants Interventional2004-10-31Recruiting
Using Transesophageal Echocardiography to Evaluate the Effect of Levosimendan on Patients With Acute Respiratory Distress Syndrome Associated With Right Ventricular Dysfunction During Mechanical Ventilation [NCT05768230]Phase 2/Phase 358 participants (Anticipated)Interventional2023-03-22Not yet recruiting
Levosimendan In Ambulatory Heart Failure Patients [NCT04705337]Phase 4350 participants (Anticipated)Interventional2021-01-01Not yet recruiting
[NCT02275013]159 participants (Actual)Observational2006-01-31Completed
Interest of Levosimendan Preconditioning for Cardiac Surgery Under CEC in Heart Failure Patients With Impaired Ejection Fraction [NCT06021587]300 participants (Anticipated)Observational2023-07-01Recruiting
Preoperative Infusion of Levosimendan in High Risk Cardiac Surgery Patients: A Retrospective Study [NCT04635293]100 participants (Actual)Interventional2012-01-01Completed
Levosimendan Administration in High Risk Cardiac Surgery Patients With Pulmonary Hypertension [NCT04599816]45 participants (Actual)Interventional2020-10-17Completed
Effect of Levosimendan on Left Ventricular Systolic Function and Heart Failure After PCI in Patients With Acute Anterior Myocardial Infarction-- Multicenter Prospective Randomized Controlled Trial [NCT04970238]Phase 4500 participants (Anticipated)Interventional2021-10-31Enrolling by invitation
Effect of Early Use of Levosimendan Versus Placebo on Top of a Conventional Strategy of Inotrope Use on a Combined Morbidity-mortality Endpoint in Patients With Cardiogenic Shock [NCT04020263]Phase 3610 participants (Anticipated)Interventional2019-12-01Not yet recruiting
Safety and Efficacy of Levosimendan in Patients With Acute Myocardial Infarction Complicated by Symptomatic Left Ventricular Failure. [NCT00324766]Phase 461 participants (Actual)Interventional2006-06-30Completed
Effects of Peroral Levosimendan in the Prevention of Further Hospitalisations in Patients With Chronic Heart Failure. A Randomised, Phase II, Double-Blind, Placebo-Controlled, Multi-Centre, Parallel-Group Study [NCT00130884]Phase 2300 participants Interventional2005-03-31Completed
Impact of Levosimendan Pretreatment on Weaning From Cardiopulmonary Bypass (CPB) in Patients With Diminished Left Ventricular Function Before Coronary Artery Bypass Grafting (CABG) [NCT00130871]Phase 260 participants Interventional2004-01-31Completed
Pharmacokinetics and Pharmacodynamics of Levosimendan During Cardiac Surgery [NCT00166127]Phase 31 participants (Actual)Interventional2005-05-31Terminated(stopped due to Unable to renegotiate an expired contract w/sponsor providing study med)
The Effect of Perioperative LevosIMendan Administration on Postoperative N-terminal pRo Brain Natriuretic Peptide Concentration in Patients With Increased cardiOVascular Risk Factors Undergoing Noncardiac surgEry - A Double-blinded Randomized Clinical Tri [NCT04329624]Phase 3230 participants (Anticipated)Interventional2020-10-10Recruiting
Efficacy and Safety of Short-term Intravenous Treatment With Simdax® Versus Dobutrex® in Decompensated Heart Failure Patients Treated With Beta-receptor Blocking Agents. [NCT00219388]Phase 460 participants Interventional2002-11-30Completed
Randomized, Multicenter Evaluation of Intravenous Levosimendan Efficacy Versus Placebo in the Short Term Treatment of Decompensated Chronic Heart Failure: the REVIVE II Study. [NCT00048425]Phase 3600 participants Interventional2002-09-30Completed
Early Management Strategies of Acute Heart Failure for Patients With NSTEMI [NCT03189901]Phase 4470 participants (Anticipated)Interventional2017-07-01Enrolling by invitation
Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support: a Multicentre, Parallel-Group, Randomised, Double-Blind, Double-Dummy Study of Levosimendan Versus Dobutamine in Patients With Acute Heart Failure. [NCT00348504]Phase 31,300 participants Interventional2003-03-31Completed
Intracoronary Administration of Levosimendan in Cardiac Surgery Patients [NCT01500785]Phase 450 participants (Actual)Interventional2018-06-15Terminated(stopped due to Change of schedule)
Myocardial Hemodynamic Effects of Levosimendan [NCT00585104]Phase 210 participants (Actual)Interventional2006-09-30Completed
Postoperative Prolonged Vasoactive-inotropic Support and Levosimendan Use After Lung Transplantation: a Retrospective Analysis of Risk Factors and Impact on Outcomes [NCT05702333]150 participants (Actual)Observational2017-02-01Completed
Levosimendan Versus Placebo Before Tricuspid Valve Surgery in Patients With Right Ventricular Dysfunction [NCT05233202]Phase 3230 participants (Anticipated)Interventional2023-01-23Recruiting
Acute and Chronic Protective Effects of Peri-interventional Administration of Levosimendan in ST Elevation Myocardial Infarctions [NCT03022877]0 participants (Actual)Interventional2017-06-30Withdrawn(stopped due to Rationale obsolete)
What Are the Changes in Cardiac Deformation Variables and Hemodynamic Parameters Following Changes in Cardiac Loading Conditions and After Administration of Two Different Inotropic Drugs. [NCT02408003]30 participants (Actual)Interventional2014-03-31Completed
Levosimendan Efficacy Assessment by Cardiopulmonary Exercise Test (CPET) [NCT02261948]Phase 442 participants (Actual)Interventional2012-09-30Completed
The Effect of Levosimendan Versus Its Combination to Magnesium Sulphate on Spinal Cord Protection Guided by NIRS in Infants Undergoing Coarctectomy: A Randomized Controlled Study. [NCT04330755]Phase 440 participants (Actual)Interventional2021-02-04Completed
Levosimendan and Global Longitudinal Strain Assessment in Cardiogenic Shock Sepsis (GLASSES 1): a Study Protocol for an Observational Study [NCT04141410]35 participants (Anticipated)Observational2019-10-21Recruiting
Levosimendan Versus Adrenaline in Patients With Low Left Ventricular Function Undergoing Elective On-Pump Coronary Artery Bypass Graft Surgery. A Randomized Controlled Study [NCT05222256]52 participants (Anticipated)Interventional2022-03-31Not yet recruiting
Effects of Levosimendan on Systolic Deformation and Diastolic Function in Patients Eligible for Aortic Valve Replacement With Left Ventricular Hypertrophy [NCT01188369]Phase 420 participants (Actual)Interventional2010-09-30Terminated(stopped due to Terminated prematurely due to high incidence of postoperative atrial fibrillation.)
Phase I Study of Two Inodilators in Neonates Undergoing Cardiovascular Surgery [NCT01576094]Phase 1/Phase 220 participants (Actual)Interventional2009-11-30Completed
Comparison of the Administration of Levosimendan and Placebo in the Preparation of Critical Patients for Heart Surgery [NCT01595737]Phase 430 participants (Actual)Interventional2011-02-28Completed
Assessment and Hemodynamic Response in CABG After Cardiopulmonary Bypass Using Intraoperative Transesophegeal Echocardiography [NCT01616069]Phase 481 participants (Actual)Interventional2012-02-29Completed
Repetitive Levosimendan Infusion for Patients With Advanced Chronic Heart Failure [NCT03437226]Phase 3264 participants (Anticipated)Interventional2018-03-08Recruiting
Preoperative Optimization Levosimendan in Heart Failure Patients Undergoing Hip Fracture [NCT02972918]19 participants (Actual)Observational2014-05-31Completed
Efficacy and Clinical Outcomes of Levosimendan in E-CPR [NCT05730907]100 participants (Anticipated)Observational2023-02-20Recruiting
Expanded Access Protocol; Intermediate Size Protocol: Levosimendan Compassionate Use in Pediatric Patients With Advanced Decompensated Heart Failure Who Are Refractory to Standard Therapy [NCT02973620]0 participants Expanded AccessNo longer available
Effects of ODM-109 on Respiratory Function in Patients With ALS. A Randomized, Double Blind, Placebo-controlled, Cross-over, 3-period, Multicenter Study With Open-label Follow-up Extension [NCT02487407]Phase 266 participants (Actual)Interventional2015-07-31Completed
Perioperative Use of Levosimendan in Patients With Impaired Right Ventricular Function Undergoing Cardiac Surgery With Cardiopulmonary Bypass [NCT05063370]Phase 240 participants (Actual)Interventional2021-08-18Active, not recruiting
Comparison of Intravenous Levosimendan and Inhalational Milrinone in High Risk Cardiac Patients With Pulmonary Hypertension [NCT04718350]40 participants (Anticipated)Interventional2021-01-27Recruiting
Prospective, Randomized, Monocenter, Double Blind, Placebo-controlled Study to Investigate the Efficacy and Safety of Levosimendan in Intensive Care Patients With Acute Kidney Injury [NCT01720030]Phase 2/Phase 368 participants (Actual)Interventional2016-09-30Active, not recruiting
Effects of Levosimendan on Diaphragm Function in Mechanically Ventilated Patients [NCT01721434]Phase 2/Phase 342 participants (Anticipated)Interventional2012-09-30Recruiting
Impact of Levosimendan Preconditioning on Critical Care and In-hospital Lengths of Stay After Cardiac Surgery With Bypass Surgery [NCT05685537]120 participants (Anticipated)Observational2022-12-15Recruiting
Levosimendan Improves Heart Failure Through Regulating 3 Cardiac Specific miRNAs (miR-660-3p, miR-665 and miR-1285-3p) in Patients With Refractory Heart Failure (NYHA III-IV) [NCT04950569]Phase 4136 participants (Anticipated)Interventional2020-10-29Recruiting
Levosimendan Infusion in Critically Ill Patients With Cardiogenic Shock [NCT04917497]43 participants (Actual)Observational2011-06-30Completed
A Double-Blind, Randomized, Placebo-Controlled Study of Levosimendan in Patients With Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass [NCT02025621]Phase 3882 participants (Actual)Interventional2014-07-31Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT00585104 (1) [back to overview]Change in Left Ventricular End-diastolic Pressure (LVEDP) Using Pressure-volume Catheter.
NCT01188369 (1) [back to overview]E/E'(Unitless)
NCT02025621 (7) [back to overview]Duration of Intensive Care Unit/Critical or Coronary Care Unit (ICU/CCU) (Days)
NCT02025621 (7) [back to overview]Incidence of Low Cardiac Output Syndrome (LCOS)
NCT02025621 (7) [back to overview]Number of Dual Efficacy Endpoint Events
NCT02025621 (7) [back to overview]Number of Quad Efficacy Endpoint Events
NCT02025621 (7) [back to overview]Occurrence of All-cause Mortality From Randomization Through Day 90
NCT02025621 (7) [back to overview]Postoperative Use of Secondary Inotrope
NCT02025621 (7) [back to overview]Rehospitalization for Any Cause Through Day 30
NCT02261948 (3) [back to overview]Change in DLCO (Diffusion Lung CO)
NCT02261948 (3) [back to overview]Change in Peak VO2 (Oxygen Consumption )
NCT02261948 (3) [back to overview]Changes in VE/VCO2
NCT03505021 (6) [back to overview]Change From Baseline in Respiratory Function of ALSFRS-R at 48 Weeks
NCT03505021 (6) [back to overview]Change From the Baseline in Clinical Global Impression CGI at 48 Weeks
NCT03505021 (6) [back to overview]Combined Assessment of Function and Survival Through 48 Weeks
NCT03505021 (6) [back to overview]Supine Borg Category Ratio 10 Scale at 12 Weeks
NCT03505021 (6) [back to overview]Supine Slow Vital Capacity (SVC)
NCT03505021 (6) [back to overview]Time to Respiratory Event Through 48 Weeks
NCT03948178 (13) [back to overview]Adverse Events Recording
NCT03948178 (13) [back to overview]Health Care Service Use During the Study (Days Spent in an Institutional Facility)
NCT03948178 (13) [back to overview]Health Care Service Use During the Study(Stays in Hospital)
NCT03948178 (13) [back to overview]Health Care Service Use During the Study(Visits to the Emergency Room)
NCT03948178 (13) [back to overview]Need for Respiratory Support Device
NCT03948178 (13) [back to overview]Number of Subjects Requiring Health and Home Care Resource Use
NCT03948178 (13) [back to overview]12-lead Electrocardiogram Assessments
NCT03948178 (13) [back to overview]Borg Category Ratio 10 Scale (CR 10)
NCT03948178 (13) [back to overview]Disease Progression
NCT03948178 (13) [back to overview]Pulse/Heart Rate Assessment
NCT03948178 (13) [back to overview]Revised ALS Functional Rating Scale (ALSFRS-R)
NCT03948178 (13) [back to overview]Subject's Status for Tracheostomy and Survival
NCT03948178 (13) [back to overview]Supine Slow Vital Capacity (SVC)

Change in Left Ventricular End-diastolic Pressure (LVEDP) Using Pressure-volume Catheter.

Left ventricular end-diastolic pressure (LVEDP) recorded from CD Leycom ConductNT software analysis. (NCT00585104)
Timeframe: From baseline to 30-minutes after levosimendan started.

InterventionmmHg (Mean)
Levosimendan, Compare Heart Function and Metabolism5.67

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E/E'(Unitless)

Ration between early transmitral flow (E) and mitral annular tissue velocity(E'). This ratio is an echocardiographic index of diastolic function (NCT01188369)
Timeframe: 4 hours before operation until 21 hour after operation

InterventionUnitless (Median)
Levosimendan12.6
Placebo13.7

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Duration of Intensive Care Unit/Critical or Coronary Care Unit (ICU/CCU) (Days)

Duration of intensive care unit/critical or coronary care unit (ICU/CCU) length of stay (LOS) in days (NCT02025621)
Timeframe: participants will be followed for during the participant's hospital stay up to 30 days

Interventiondays (Median)
Levosimendan2.8
Placebo2.9

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Incidence of Low Cardiac Output Syndrome (LCOS)

Use of a mechanical cardiac assist device within 5 days after surgery, two consecutive measurements of low cardiac output (defined as a cardiac output of ≤2.0 liters per minute per square meter of bodysurface area), one measurement of low cardiac output plus the use of two or more inotropes at or beyond 24 hours after surgery, or the use of two or more inotropes at or beyond 24 hours after surgery with the indicated reason being low cardiac output. (NCT02025621)
Timeframe: 5 days

InterventionParticipants (Count of Participants)
Levosimendan78
Placebo108

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Number of Dual Efficacy Endpoint Events

The all-cause death at 30 days or use of mechanical assist device (IABP, LVAD or ECMO) following the start of surgery for poor cardiac function despite inotropic support and adequate fluid replacement) through Day 5 (NCT02025621)
Timeframe: 30 days

Interventionevents (Number)
Levosimendan56
Placebo48

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Number of Quad Efficacy Endpoint Events

Composite of all-cause death (at 30 days), or perioperative nonfatal MI [CK-MB >10xULN or >100 ng/mL, CK-MB >5xULN or 50 ng/mL with new Q wave (>0.04 seconds wide in two contiguous leads) or new left bundle branch block)] (through Day 5), or need for renal dialysis (through Day 30), or use of mechanical assist device (IABP, LVAD or ECMO) following the start of surgery for poor cardiac function despite inotropic support and adequate fluid replacement) (through Day 5) (NCT02025621)
Timeframe: 30 days

Interventionevents (Number)
Levosimendan105
Placebo103

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Occurrence of All-cause Mortality From Randomization Through Day 90

(NCT02025621)
Timeframe: 90 days

InterventionParticipants (Count of Participants)
Levosimendan20
Placebo30

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Postoperative Use of Secondary Inotrope

Use of (dobutamine, milrinone, epinephrine, dopamine) associated with index surgical procedure at 24 hours after initiation of surgery (NCT02025621)
Timeframe: 24 hours

InterventionParticipants (Count of Participants)
Levosimendan235
Placebo264

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Rehospitalization for Any Cause Through Day 30

(NCT02025621)
Timeframe: 30 days

InterventionParticipants (Count of Participants)
Levosimendan54
Placebo48

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Change in DLCO (Diffusion Lung CO)

Levosimendan induced changes on DLCO ( Diffusion Lung CO). DLCO is measured by the single breath-constant expiratory flow technique (Sensor Medics 2200, Yorba Linda, CA) and we calculate also the DLCO adjusted for hemoglobin. Dilution of CH4 is used to measure alveolar volume. (NCT02261948)
Timeframe: 48 hours

Interventionml/mmHg/min (Mean)
Levosimendan-0.96
Placebo0.88

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Change in Peak VO2 (Oxygen Consumption )

Primary endpoints: Levosimendan induced changes in peak VO2 (Oxygen consumption ) (NCT02261948)
Timeframe: 48 hours

Interventionml/kg/min (Mean)
Levosimendan1.21
Placebo0.48

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Changes in VE/VCO2

Levosimendan induced changes on VE/VCO2 (VE: Expired Volume - VCO2: carbon dioxide production) relationship (NCT02261948)
Timeframe: 48 hours

InterventionVE/VCO2 Slope (Mean)
Levosimendan-5.34
Placebo-0.91

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Change From Baseline in Respiratory Function of ALSFRS-R at 48 Weeks

ALSFRS-R scale contains 3 items that relate to respiratory function: severity of dyspnoea, occurrence of orthopnoea (shortness of breath when lying flat) and the use of mechanical ventilation for respiratory insufficiency. These are added together to created the respiratory domain with a score range 0-12 (where 12 represents normal function). Although individual items and patients vary, ALSFRS-R typically declines at a relatively constant rate over time. Plotted over time the slope of the line obtained indicates the speed of progression and thus an effective treatment might be expected to reduce the slope of decline. (NCT03505021)
Timeframe: Slope of decline at 48 weeks

InterventionScore on a scale/month (Least Squares Mean)
Levosimendan-0.191
Placebo for Levosimendan-0.205

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Change From the Baseline in Clinical Global Impression CGI at 48 Weeks

Visual Analogue Scale 0-100 millimeters, rated by study subjects. Score 0 indicates that the subject is completely well without any disability and score 100 indicates the worst possible severity of the condition. (NCT03505021)
Timeframe: The change from baseline at 48 weeks

Interventionunits on a scale (Least Squares Mean)
Levosimendan17.048
Placebo for Levosimendan13.285

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Combined Assessment of Function and Survival Through 48 Weeks

Scale: The ALS Functional Rating Scale - Revised. This scale includes 12 items. Each item was scored from 0 to 4. Total score is the sum of the scores of all 12 items. Each subject is ranked according to time-to-death (earlier deaths ranked lower than later deaths). Subjects who survive are ranked more favorably than subjects who died. Among the survivors, subjects are ranked according to change in ALSFRS-R (greater worsening of ALSFRS-R is ranked lower than after deaths). Subjects who survive are ranked more favorably than subjects who died. Among the survivors, subjects are ranked according to change in ALSFRS-R (greater worsening of ALSFRS-R is ranked lower than less worsening or an improvement in ALSFRS-R). The ranked scores range from 001 to 496 (the number of participants assessed for the Outcome Measure) with larger rank score numbers associated with a better outcome. (NCT03505021)
Timeframe: Mean rank at 48 weeks

InterventionScores on a rank scale (Least Squares Mean)
Levosimendan239.85
Placebo for Levosimendan229.16

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Supine Borg Category Ratio 10 Scale at 12 Weeks

Patients rated their perception of the severity of their dysnoea using the Borg scale. The scale ranges from 0 (no dyspnoea) to 10 (maximal). Each category is numbered and most (not all) have verbal cues. At each assessment the patient scored the category they felt best described their symptoms. The analysis measured change from baseline at 12 weeks, where a negative score indicates improvement and a positive score reflects worsening. (NCT03505021)
Timeframe: Change from baseline at 12 weeks

Interventionscore on a scale (Least Squares Mean)
Levosimendan-0.152
Placebo for Levosimendan0.120

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Supine Slow Vital Capacity (SVC)

Change from baseline to 12 weeks, expressed as % of predicted normal. (NCT03505021)
Timeframe: The change from baseline at 12 weeks

Interventionpercentage (Least Squares Mean)
Levosimendan-6.731
Placebo for Levosimendan-6.988

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Time to Respiratory Event Through 48 Weeks

"ALSFRS-R scale contains 3 items that relate to respiratory function: severity of dyspnoea, occurrence of orthopnoea (shortness of breath when lying flat) and the use of mechanical ventilation for respiratory insufficiency. A reduction in any one of these items was considered a respiratory event. Not all patients receive ventilatory support, despite respiratory insufficiency: meeting protocolised criteria for NIV relates to patients without NIV whose slow vital capacity declined to a level that would ordinarily trigger such treatment." (NCT03505021)
Timeframe: Time to event through 48 weeks

InterventionDays (Median)
Levosimendan90
Placebo for Levosimendan126

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Adverse Events Recording

Adverse Events as subject counts and proportions (%) of subject per Adverse Event (NCT03948178)
Timeframe: From signing informed consent until 14-25 days after the last study treatment for all patients, an average of 23.5 weeks.

InterventionParticipants (Count of Participants)
Levosimendan161

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Health Care Service Use During the Study (Days Spent in an Institutional Facility)

The number of days spent in an institutional facility were recorded throughout the study using a diary given to the study subjects (NCT03948178)
Timeframe: From baseline to the end of the study(2-48 weeks after study entry)

Interventiondays (Mean)
Levosimendan4.7

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Health Care Service Use During the Study(Stays in Hospital)

The number of night stays in hospital were recorded throughout the study using a diary given to the study subjects (NCT03948178)
Timeframe: From baseline to the end of the study(2-48 weeks after study entry)

InterventionNights (Mean)
Levosimendan0.7

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Health Care Service Use During the Study(Visits to the Emergency Room)

The number of visits to the emergency room were recorded throughout the study using a diary given to the study subjects (NCT03948178)
Timeframe: From baseline to the end of the study(2-48 weeks after study entry)

Interventionvisits (Mean)
Levosimendan0.1

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Need for Respiratory Support Device

Time to respiratory device support (non invasive) or death (NCT03948178)
Timeframe: Time to event at study completion (subject's last visit, 2-48 weeks after study entry)

Interventiondays (Mean)
Levosimendan259.5

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Number of Subjects Requiring Health and Home Care Resource Use

The number of study subjects requiring Health and home care resource use was aggregated over the course of the study for each subject and summarised using descriptive statistics. (NCT03948178)
Timeframe: Baseline through study completion (2- 48 weeks after study entry)

InterventionParticipants (Count of Participants)
Levosimendan95

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12-lead Electrocardiogram Assessments

Summarisation of any abnormal 12-lead ECG findings using descriptive statistics. (NCT03948178)
Timeframe: Baseline, week 2, week 4, month 3, month 6, end-of-study(subject's last visit, 2-48 weeks after study entry)

InterventionParticipants (Count of Participants)
Baseline abnormal ECGWeek 2 abnormal ECGWeek 4 abnormal ECGMonth 3 abnormal ECGMonth 6 abnormal ECGEnd-of study abnormal ECG
Levosimendan695643271136

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Borg Category Ratio 10 Scale (CR 10)

Patients rated their perception of the severity of their dyspnea using the Borg Category Ration 10 scale (CR 10). The scale ranges from 0(no dysponea) to 10 (maximal dyspnea). each category is numbered and most but not all have verbal cues. At each assessment the patient scored the category they felt best described their symptoms. The analysis measured change from baseline to the end of the study in both a supine and sitting position where a negative score indicates improvement and a positive score reflects worsening. (NCT03948178)
Timeframe: Baseline through study completion (week 2, week 4, month 3, month 6, end of study (subject's last visit, 2-48 weeks after study entry)

Interventionunits on a scale (Mean)
Baseline in Borg score Supine positionChange from baseline in Borg score supine at week 2chenge from baseline in Borg score week 4Change from baseline in Borg score supine at month 3Change from baseline in Borg score supine at month 6Change from baseline in Borg score supine at end of studyBaseline Borg score sittingChange from baseline in Borg score sitting at week 2Change from baseline in Borg score sitting at week 4Change from baseline in Borg score sitting at month 3Change from baseline in Borg score sitting month 6Change from baseline in Borg score sitting at end of study
Levosimendan2.520.150.400.541.611.582.190.010.340.611.21.07

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Disease Progression

Count of study withdrawals due to disease progression (NCT03948178)
Timeframe: From Baseline through study completion(subject's last visit, 2-48 weeks after study entry)

InterventionParticipants (Count of Participants)
Total withdrawal due to sponsor terminating the studyNumber of withdrawals due to disease progression
Levosimendan16430

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Pulse/Heart Rate Assessment

Actual values and changes from baseline in supine pre-dose pulse/heart rate were summarised using descriptive statistics . (NCT03948178)
Timeframe: Change in pulse and heart rate(from ECG recording) from Baseline, week 2, week 4, week 6 (pulse rate only), Month 3, Month 6, end of study (subject's last visit, 2-48 weeks after study entry)

Interventionbeats per minute (bpm) (Mean)
Change in pulse rate at week 2Change in pulse rate at 4 weeksChange in pulse rate at week 6chnage in pulse rate at Month 3Change in pulse rate at month 6Change in pulse rate at end-of-studyChange in Heart rate at week 2Change in Heart rate at week 4Change in heart rate at Month 3Change in heart rate at month 6Change in heart rate at end-of-studyBaseline supine pulse rateBaseline supine heart rate
Levosimendan7.010.08.510.412.83.59.112.812.615.05.375.873.5

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Revised ALS Functional Rating Scale (ALSFRS-R)

ALSFRS-R scale contains 3 parameters related to respiratory function: Severity of dyspnea, occurrence of orthopnea (shortness of breath when in supine position i.e. lying flat), and the use of mechanical ventilation for respiratory in sufficiency. These 3 parameters are combined to create the respiratory domain with a score of 0-12(where 12 is normal function). Although individual items and patients vary, ALSFRS-R typically declines at a relatively constant rate over time. Plotted over time the slope of the line obtained indicates the speed of progression and thus an effective treatment might be expected ro reduce the slope of decline. (NCT03948178)
Timeframe: Change from Baseline in respiratory function of ALSFRS-R at study completion (subject's last visit, 2-48 weeks after study entry)

InterventionScore on a scale (Mean)
Change from baseline in respiratory function ALSFR-S at end of studyBaseline respiratory ALSFRS-R
Levosimendan-1.29.4

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Subject's Status for Tracheostomy and Survival

Number of patients with the need for tracheostomy or who died whilst on treatment from baseline to the end of the study was summarised using descriptive statistics. (NCT03948178)
Timeframe: Baseline to end of study (average 2-48 weeks after study entry

InterventionParticipants (Count of Participants)
Number of participants who died from baseline to end of the study treatmentNumber of participants requiring tracheostomy from baseline to the end of the study treatment
Levosimendan50

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Supine Slow Vital Capacity (SVC)

Change from baseline in supine and sitting SVC (all devices) through to the end of the study, expressed as a % of predicted normal (NCT03948178)
Timeframe: The change from Baseline, week 2, week 4, month 3, month 6, end-of-study (subject's last visit, 2-48 weeks after study entry)

Intervention% of predicted normal (Mean)
Change from baseline in supine SVC at week 2Change from baseline in supine SVC at week 4Change from baseline in supine SVC at month 3Change from baseline in supine SVC at month 6Change from baseline in supine SVC at the end of the studyChange from baseline in sitting SVC at week 2Change from baseline in sitting SVC at week 4Change from baseline in sitting SVC month 3Change from baseline in sitting SVC month 6Change from baseline in sitting SVC at the end of the studyBaseline Supine SVC (% predicted normalBaseline Sitting SVC (% predicted normal)
Levosimendan1.50.8-3.5-5.3-5.61.42.1-1.9-6.1-7.354.461.4

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SubstanceRelationship StrengthStudiesTrialsClassesRoles
lactic acid
Lactic Acid: A normal intermediate in the fermentation (oxidation, metabolism) of sugar. The concentrated form is used internally to prevent gastrointestinal fermentation. (From Stedman, 26th ed). 2-hydroxypropanoic acid : A 2-hydroxy monocarboxylic acid that is propanoic acid in which one of the alpha-hydrogens is replaced by a hydroxy group.		8.181812-hydroxy monocarboxylic acidalgal metabolite;
Daphnia magna metabolite
diacetyl
butane-2,3-dione : An alpha-diketone that is butane substituted by oxo groups at positions 2 and 3. It is a metabolite produced during the malolactic fermentation.		2.0510alpha-diketoneEscherichia coli metabolite;
Saccharomyces cerevisiae metabolite
glycerol
Moon: The natural satellite of the planet Earth. It includes the lunar cycles or phases, the lunar month, lunar landscapes, geography, and soil.		7.5220alditol;
triol		algal metabolite;
detergent;
Escherichia coli metabolite;
geroprotector;
human metabolite;
mouse metabolite;
osmolyte;
Saccharomyces cerevisiae metabolite;
solvent
hydrogen carbonate
Bicarbonates: Inorganic salts that contain the -HCO3 radical. They are an important factor in determining the pH of the blood and the concentration of bicarbonate ions is regulated by the kidney. Levels in the blood are an index of the alkali reserve or buffering capacity.. hydrogencarbonate : The carbon oxoanion resulting from the removal of a proton from carbonic acid.		2.0110carbon oxoanioncofactor;
Escherichia coli metabolite;
human metabolite;
mouse metabolite;
Saccharomyces cerevisiae metabolite
methanol
Methanol: A colorless, flammable liquid used in the manufacture of FORMALDEHYDE and ACETIC ACID, in chemical synthesis, antifreeze, and as a solvent. Ingestion of methanol is toxic and may cause blindness.. primary alcohol : A primary alcohol is a compound in which a hydroxy group, -OH, is attached to a saturated carbon atom which has either three hydrogen atoms attached to it or only one other carbon atom and two hydrogen atoms attached to it.. methanol : The primary alcohol that is the simplest aliphatic alcohol, comprising a methyl and an alcohol group.		2.2510alkyl alcohol;
one-carbon compound;
primary alcohol;
volatile organic compound		amphiprotic solvent;
Escherichia coli metabolite;
fuel;
human metabolite;
mouse metabolite;
Mycoplasma genitalium metabolite
nitrates
Nitrates: Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical.		2.5320monovalent inorganic anion;
nitrogen oxoanion;
reactive nitrogen species
nitroxyl
nitroxyl: hydroxamic acid oxidized to nitroxyl free radical. nitroxyl : A nitrogen oxoacid consisting of an oxygen atom double-bonded to an NH group.		2.2110nitrogen oxoacid
nitrites
Nitrites: Salts of nitrous acid or compounds containing the group NO2-. The inorganic nitrites of the type MNO2 (where M=metal) are all insoluble, except the alkali nitrites. The organic nitrites may be isomeric, but not identical with the corresponding nitro compounds. (Grant & Hackh's Chemical Dictionary, 5th ed)		2.5320monovalent inorganic anion;
nitrogen oxoanion;
reactive nitrogen species		human metabolite
pyruvic acid
Pyruvic Acid: An intermediate compound in the metabolism of carbohydrates, proteins, and fats. In thiamine deficiency, its oxidation is retarded and it accumulates in the tissues, especially in nervous structures. (From Stedman, 26th ed). pyruvic acid : A 2-oxo monocarboxylic acid that is the 2-keto derivative of propionic acid. It is a metabolite obtained during glycolysis.		2.45202-oxo monocarboxylic acidcofactor;
fundamental metabolite
thiamine
thiamine(1+) : A primary alcohol that is 1,3-thiazol-3-ium substituted by (4-amino-2-methylpyrimidin-5-yl)methyl, methyl and 2-hydroxyethyl groups at positions 3, 4 and 5, respectively.		3.5110primary alcohol;
vitamin B1		Escherichia coli metabolite;
human metabolite;
mouse metabolite;
Saccharomyces cerevisiae metabolite
urea
pseudourea: clinical use; structure. isourea : A carboximidic acid that is the imidic acid tautomer of urea, H2NC(=NH)OH, and its hydrocarbyl derivatives.		4.9560isourea;
monocarboxylic acid amide;
one-carbon compound		Daphnia magna metabolite;
Escherichia coli metabolite;
fertilizer;
flour treatment agent;
human metabolite;
mouse metabolite;
Saccharomyces cerevisiae metabolite
n-(3-(aminomethyl)benzyl)acetamidine
N-(3-(aminomethyl)benzyl)acetamidine: structure in first source. N-[3-(aminomethyl)benzyl]acetamidine : An aralkylamine that is Nbenzylacetamidine substituted at position 3 on the benzene ring by an aminomethyl group. An inhibitor of nitric oxide synthase.		2.1110aralkylamine;
carboxamidine;
primary amino compound		angiogenesis inhibitor;
EC 1.14.13.39 (nitric oxide synthase) inhibitor;
geroprotector
4-aminopyridine
[no description available]		7.7230aminopyridine;
aromatic amine		avicide;
orphan drug;
potassium channel blocker
5-hydroxydecanoate
5-hydroxydecanoic acid: Potassium Channel Blocker; RN refers to parent cpd		3.1950medium-chain fatty acid
p-aminohippuric acid
p-Aminohippuric Acid: The glycine amide of 4-aminobenzoic acid. Its sodium salt is used as a diagnostic aid to measure effective renal plasma flow (ERPF) and excretory capacity.. p-aminohippurate : A hippurate that is the conjugate base of p-aminohippuric acid, arising from deprotonation of the carboxy group.. p-aminohippuric acid : An N-acylglycine that is the 4-amino derivative of hippuric acid; used as a diagnostic agent in the measurement of renal plasma flow.		4.4811N-acylglycineDaphnia magna metabolite
amiodarone
Amiodarone: An antianginal and class III antiarrhythmic drug. It increases the duration of ventricular and atrial muscle action by inhibiting POTASSIUM CHANNELS and VOLTAGE-GATED SODIUM CHANNELS. There is a resulting decrease in heart rate and in vascular resistance.. amiodarone : A member of the class of 1-benzofurans that is 1-benzofuran substituted by a butyl group at position 2 and a 4-[2-(diethylamino)ethoxy]-3,5-diiodobenzoyl group at position 3. It is a cardiovascular drug used for the treatment of cardiac dysrhythmias.		7.44201-benzofurans;
aromatic ketone;
organoiodine compound;
tertiary amino compound		cardiovascular drug
amlodipine
Amlodipine: A long-acting dihydropyridine calcium channel blocker. It is effective in the treatment of ANGINA PECTORIS and HYPERTENSION.. amlodipine : A fully substituted dialkyl 1,4-dihydropyridine-3,5-dicarboxylate derivative, which is used for the treatment of hypertension, chronic stable angina and confirmed or suspected vasospastic angina.		7.4620dihydropyridine;
ethyl ester;
methyl ester;
monochlorobenzenes;
primary amino compound		antihypertensive agent;
calcium channel blocker;
vasodilator agent
atenolol
Atenolol: A cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect.. atenolol : An ethanolamine compound having a (4-carbamoylmethylphenoxy)methyl group at the 1-position and an N-isopropyl substituent.		2.0510ethanolamines;
monocarboxylic acid amide;
propanolamine		anti-arrhythmia drug;
antihypertensive agent;
beta-adrenergic antagonist;
environmental contaminant;
sympatholytic agent;
xenobiotic
bepridil
Bepridil: A long-acting calcium-blocking agent with significant anti-anginal activity. The drug produces significant coronary vasodilation and modest peripheral effects. It has antihypertensive and selective anti-arrhythmia activities and acts as a calmodulin antagonist.. bepridil : A tertiary amine in which the substituents on nitrogen are benzyl, phenyl and 3-(2-methylpropoxy)-2-(pyrrolidin-1-yl)propyl.		2.1310pyrrolidines;
tertiary amine		anti-arrhythmia drug;
antihypertensive agent;
calcium channel blocker;
vasodilator agent
bupivacaine
Bupivacaine: A widely used local anesthetic agent.. 1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide : A piperidinecarboxamide obtained by formal condensation of the carboxy group of N-butylpipecolic acid with the amino group of 2,6-dimethylaniline.. bupivacaine : A racemate composed of equimolar amounts of dextrobupivacaine and levobupivacaine. Used (in the form of its hydrochloride hydrate) as a local anaesthetic.		2.8330aromatic amide;
piperidinecarboxamide;
tertiary amino compound
bupranolol
Bupranolol: An adrenergic-beta-2 antagonist that has been used for cardiac arrhythmia, angina pectoris, hypertension, glaucoma, and as an antithrombotic.		210aromatic ether
verapamil
Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent.. verapamil : A racemate comprising equimolar amounts of dexverapamil and (S)-verapamil. An L-type calcium channel blocker of the phenylalkylamine class, it is used (particularly as the hydrochloride salt) in the treatment of hypertension, angina pectoris and cardiac arrhythmia, and as a preventive medication for migraine.. 2-(3,4-dimethoxyphenyl)-5-{[2-(3,4-dimethoxyphenyl)ethyl](methyl)amino}-2-(propan-2-yl)pentanenitrile : A tertiary amino compound that is 3,4-dimethoxyphenylethylamine in which the hydrogens attached to the nitrogen are replaced by a methyl group and a 4-cyano-4-(3,4-dimethoxyphenyl)-5-methylhexyl group.		3.4470aromatic ether;
nitrile;
polyether;
tertiary amino compound
carvedilol
[no description available]		4.3722carbazoles;
secondary alcohol;
secondary amino compound		alpha-adrenergic antagonist;
antihypertensive agent;
beta-adrenergic antagonist;
cardiovascular drug;
vasodilator agent
cilostamide
cilostamide: selective inhibitor of cyclic AMP phosphodiesterase & platelet aggregation; structure		2.110quinolines
cilostazol
[no description available]		7.1710lactam;
tetrazoles		anticoagulant;
bronchodilator agent;
EC 3.1.4.17 (3',5'-cyclic-nucleotide phosphodiesterase) inhibitor;
fibrin modulating drug;
neuroprotective agent;
platelet aggregation inhibitor;
vasodilator agent
dichlorvos
Dichlorvos: An organophosphorus insecticide that inhibits ACETYLCHOLINESTERASE.. dichlorvos : An alkenyl phosphate that is the 2,2-dichloroethenyl ester of dimethyl phosphate.		7.0710alkenyl phosphate;
dialkyl phosphate;
organochlorine acaricide;
organophosphate insecticide		anthelminthic drug;
antibacterial agent;
antifungal agent;
EC 3.1.1.7 (acetylcholinesterase) inhibitor;
EC 3.1.1.8 (cholinesterase) inhibitor
fluconazole
Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal CANDIDIASIS and cryptococcal MENINGITIS in AIDS.. fluconazole : A member of the class of triazoles that is propan-2-ol substituted at position 1 and 3 by 1H-1,2,4-triazol-1-yl groups and at position 2 by a 2,4-difluorophenyl group. It is an antifungal drug used for the treatment of mucosal candidiasis and for systemic infections including systemic candidiasis, coccidioidomycosis, and cryptococcosis.		2.0210conazole antifungal drug;
difluorobenzene;
tertiary alcohol;
triazole antifungal drug		environmental contaminant;
P450 inhibitor;
xenobiotic
furosemide
Furosemide: A benzoic-sulfonamide-furan. It is a diuretic with fast onset and short duration that is used for EDEMA and chronic RENAL INSUFFICIENCY.. furosemide : A chlorobenzoic acid that is 4-chlorobenzoic acid substituted by a (furan-2-ylmethyl)amino and a sulfamoyl group at position 2 and 5 respectively. It is a diuretic used in the treatment of congestive heart failure.		12.4883chlorobenzoic acid;
furans;
sulfonamide		environmental contaminant;
loop diuretic;
xenobiotic
glyburide
Glyburide: An antidiabetic sulfonylurea derivative with actions like those of chlorpropamide. glyburide : An N-sulfonylurea that is acetohexamide in which the acetyl group is replaced by a 2-(5-chloro-2-methoxybenzamido)ethyl group.		5.55161monochlorobenzenes;
N-sulfonylurea		anti-arrhythmia drug;
EC 2.7.1.33 (pantothenate kinase) inhibitor;
EC 3.6.3.49 (channel-conductance-controlling ATPase) inhibitor;
hypoglycemic agent
1-(5-isoquinolinesulfonyl)-2-methylpiperazine
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine: A specific protein kinase C inhibitor, which inhibits superoxide release from human neutrophils (PMN) stimulated with phorbol myristate acetate or synthetic diacylglycerol.. 1-(5-isoquinolinesulfonyl)-2-methylpiperazine : A member of the class of N-sulfonylpiperazines that is 2-methylpiperazine substituted at position 1 by a 5-isoquinolinesulfonyl group.		1.9910isoquinolines;
N-sulfonylpiperazine		EC 2.7.11.13 (protein kinase C) inhibitor
amrinone
Amrinone: A positive inotropic cardiotonic (CARDIOTONIC AGENTS) with vasodilator properties, phosphodiesterase 3 inhibitory activity, and the ability to stimulate calcium ion influx into the cardiac cell.. amrinone : A 3,4'-bipyridine substituted at positions 5 and 6 by an amino group and a keto function respectively. A pyridine phosphodiesterase 3 inhibitor, it is a drug that may improve the prognosis in patients with congestive heart failure.		2.420bipyridinesEC 3.1.4.* (phosphoric diester hydrolase) inhibitor
1-methyl-3-isobutylxanthine
1-Methyl-3-isobutylxanthine: A potent cyclic nucleotide phosphodiesterase inhibitor; due to this action, the compound increases cyclic AMP and cyclic GMP in tissue and thereby activates CYCLIC NUCLEOTIDE-REGULATED PROTEIN KINASES. 3-isobutyl-1-methylxanthine : An oxopurine that is xanthine which is substituted at positions 1 and 3 by methyl and isobutyl groups, respectively.		2.01103-isobutyl-1-methylxanthine
isoflurane
Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.		2.5720organofluorine compoundinhalation anaesthetic
isoproterenol
Isoproterenol: Isopropyl analog of EPINEPHRINE; beta-sympathomimetic that acts on the heart, bronchi, skeletal muscle, alimentary tract, etc. It is used mainly as bronchodilator and heart stimulant.. isoprenaline : A secondary amino compound that is noradrenaline in which one of the hydrogens attached to the nitrogen is replaced by an isopropyl group. A sympathomimetic acting almost exclusively on beta-adrenergic receptors, it is used (mainly as the hydrochloride salt) as a bronghodilator and heart stimulant for the management of a variety of cardiac disorders.		4.05140catechols;
secondary alcohol;
secondary amino compound		beta-adrenergic agonist;
bronchodilator agent;
cardiotonic drug;
sympathomimetic agent
losartan
Losartan: An antagonist of ANGIOTENSIN TYPE 1 RECEPTOR with antihypertensive activity due to the reduced pressor effect of ANGIOTENSIN II.. losartan : A biphenylyltetrazole where a 1,1'-biphenyl group is attached at the 5-position and has an additional trisubstituted imidazol-1-ylmethyl group at the 4'-position		3.1110biphenylyltetrazole;
imidazoles		angiotensin receptor antagonist;
anti-arrhythmia drug;
antihypertensive agent;
endothelin receptor antagonist
2-(4-morpholinyl)-8-phenyl-4h-1-benzopyran-4-one
2-(4-morpholinyl)-8-phenyl-4H-1-benzopyran-4-one: specific inhibitor of phosphatidylinositol 3-kinase; structure in first source		2.1110chromones;
morpholines;
organochlorine compound		autophagy inhibitor;
EC 2.7.1.137 (phosphatidylinositol 3-kinase) inhibitor;
geroprotector
metaproterenol
Metaproterenol: A beta-2 adrenergic agonist used in the treatment of ASTHMA and BRONCHIAL SPASM.. orciprenaline : A racemate composed of equimolar amounts of (R)- and (S)-orciprenaline. Used (as its sulfate salt) to relax the airway muscles and improve breathing for patients suffering from asthma or bronchitis.. 5-[1-hydroxy-2-(isopropanylamino)ethyl]benzene-1,3-diol : A member of the class of resorcinols bearing an additional 1-hydroxy-2-(isopropanylamino)ethyl substituent at position 5 of resorcinol itself.		2.0610aralkylamino compound;
phenylethanolamines;
resorcinols;
secondary alcohol;
secondary amino compound
metoprolol
Metoprolol: A selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS.. metoprolol : A propanolamine that is 1-(propan-2-ylamino)propan-2-ol substituted by a 4-(2-methoxyethyl)phenoxy group at position 1.		7.7730aromatic ether;
propanolamine;
secondary alcohol;
secondary amino compound		antihypertensive agent;
beta-adrenergic antagonist;
environmental contaminant;
geroprotector;
xenobiotic
milrinone
[no description available]		16.18120bipyridines;
nitrile;
pyridone		cardiotonic drug;
EC 3.1.4.17 (3',5'-cyclic-nucleotide phosphodiesterase) inhibitor;
platelet aggregation inhibitor;
vasodilator agent
apnea
Apnea: A transient absence of spontaneous respiration.		2.0210purine nucleoside
nicardipine
Nicardipine: A potent calcium channel blockader with marked vasodilator action. It has antihypertensive properties and is effective in the treatment of angina and coronary spasms without showing cardiodepressant effects. It has also been used in the treatment of asthma and enhances the action of specific antineoplastic agents.. nicardipine : A racemate comprising equimolar amounts of (R)- and (S)-nicardipine. It is a calcium channel blocker which is used to treat hypertension.. 2-[benzyl(methyl)amino]ethyl methyl 2,6-dimethyl-4-(3-nitrophenyl)-1,4-dihydropyridine-3,5-dicarboxylate : A dihydropyridine that is 1,4-dihydropyridine substituted by a methyl, {2-[benzyl(methyl)amino]ethoxy}carbonyl, 3-nitrophenyl, methoxycarbonyl and methyl groups at positions 2, 3, 4, 5 and 6, respectively.		3.1510benzenes;
C-nitro compound;
diester;
dihydropyridine;
methyl ester;
tertiary amino compound
nimodipine
Nimodipine: A calcium channel blockader with preferential cerebrovascular activity. It has marked cerebrovascular dilating effects and lowers blood pressure.. nimodipine : A dihydropyridine that is 1,4-dihydropyridine which is substituted by methyl groups at positions 2 and 6, a (2-methoxyethoxy)carbonyl group at position 3, a m-nitrophenyl group at position 4, and an isopropoxycarbonyl group at position 5. An L-type calcium channel blocker, it acts particularly on cerebral circulation, and is used both orally and intravenously for the prevention and treatment of subarachnoid hemorrhage from ruptured intracranial aneurysm.		2.21102-methoxyethyl ester;
C-nitro compound;
dicarboxylic acids and O-substituted derivatives;
diester;
dihydropyridine;
isopropyl ester		antihypertensive agent;
calcium channel blocker;
cardiovascular drug;
vasodilator agent
nitroglycerin
Nitroglycerin: A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.. nitroglycerol : A nitrate ester that is glycerol in which nitro group(s) replace the hydrogen(s) attached to one or more of the hydroxy groups.. nitroglycerin : A nitroglycerol that is glycerol in which the hydrogen atoms of all three hydroxy groups are replaced by nitro groups. It acts as a prodrug, releasing nitric oxide to open blood vessels and so alleviate heart pain.		4.9221nitroglycerolexplosive;
muscle relaxant;
nitric oxide donor;
prodrug;
tocolytic agent;
vasodilator agent;
xenobiotic
oxidopamine
Oxidopamine: A neurotransmitter analogue that depletes noradrenergic stores in nerve endings and induces a reduction of dopamine levels in the brain. Its mechanism of action is related to the production of cytolytic free-radicals.. oxidopamine : A benzenetriol that is phenethylamine in which the hydrogens at positions 2, 4, and 5 on the phenyl ring are replaced by hydroxy groups. It occurs naturally in human urine, but is also produced as a metabolite of the drug DOPA (used for the treatment of Parkinson's disease).		2.2510benzenetriol;
catecholamine;
primary amino compound		drug metabolite;
human metabolite;
neurotoxin
papaverine
Papaverine: An alkaloid found in opium but not closely related to the other opium alkaloids in its structure or pharmacological actions. It is a direct-acting smooth muscle relaxant used in the treatment of impotence and as a vasodilator, especially for cerebral vasodilation. The mechanism of its pharmacological actions is not clear, but it apparently can inhibit phosphodiesterases and it may have direct actions on calcium channels.. papaverine : A benzylisoquinoline alkaloid that is isoquinoline substituted by methoxy groups at positions 6 and 7 and a 3,4-dimethoxybenzyl group at position 1. It has been isolated from Papaver somniferum.		7.4820benzylisoquinoline alkaloid;
dimethoxybenzene;
isoquinolines		antispasmodic drug;
vasodilator agent
pd 98059
2-(2-amino-3-methoxyphenyl)-4H-1-benzopyran-4-one: inhibits MAP kinase kinase (MEK) activity, p42 MAPK and p44 MAPK; structure in first source. 2-(2-amino-3-methoxyphenyl)chromen-4-one : A member of the class of monomethoxyflavones that is 3'-methoxyflavone bearing an additional amino substituent at position 2'.		2.0810aromatic amine;
monomethoxyflavone		EC 2.7.11.24 (mitogen-activated protein kinase) inhibitor;
geroprotector
pentoxifylline
[no description available]		3.2110oxopurine
perhexiline
Perhexiline: 2-(2,2-Dicyclohexylethyl)piperidine. Coronary vasodilator used especially for angina of effort. It may cause neuropathy and hepatitis.		3.1410piperidinescardiovascular drug
pimobendan
pimobendan: produces arterial & venous dilatation in dogs; structure given in first source		12.56180benzimidazoles;
pyridazinone		cardiotonic drug;
EC 3.1.4.* (phosphoric diester hydrolase) inhibitor;
vasodilator agent
pinacidil
Pinacidil: A guanidine that opens POTASSIUM CHANNELS producing direct peripheral vasodilatation of the ARTERIOLES. It reduces BLOOD PRESSURE and peripheral resistance and produces fluid retention. (Martindale The Extra Pharmacopoeia, 31st ed)		210pyridines
potassium chloride
Potassium Chloride: A white crystal or crystalline powder used in BUFFERS; FERTILIZERS; and EXPLOSIVES. It can be used to replenish ELECTROLYTES and restore WATER-ELECTROLYTE BALANCE in treating HYPOKALEMIA.. potassium chloride : A metal chloride salt with a K(+) counterion.		2.7230inorganic chloride;
inorganic potassium salt;
potassium salt		fertilizer
practolol
Practolol: A beta-1 adrenergic antagonist that has been used in the emergency treatment of CARDIAC ARRYTHMIAS.. practolol : N-(4-Hydroxyphenyl)acetamide in which the hydrogen of the phenolic hydroxy group is substituted by a 3-(isopropylaminoamino)-2-hydroxypropyl group. A selective beta blocker, it has been used in the emergency treatment of cardiac arrhythmias.		210acetamides;
ethanolamines;
propanolamine;
secondary alcohol;
secondary amino compound		anti-arrhythmia drug;
beta-adrenergic antagonist
procaine
Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016).. procaine : A benzoate ester, formally the result of esterification of 4-aminobenzoic acid with 2-diethylaminoethanol but formed experimentally by reaction of ethyl 4-aminobenzoate with 2-diethylaminoethanol.		2.0710benzoate ester;
substituted aniline;
tertiary amino compound		central nervous system depressant;
drug allergen;
local anaesthetic;
peripheral nervous system drug
propranolol
Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs.. propranolol : A propanolamine that is propan-2-ol substituted by a propan-2-ylamino group at position 1 and a naphthalen-1-yloxy group at position 3.		3.1750naphthalenes;
propanolamine;
secondary amine		anti-arrhythmia drug;
antihypertensive agent;
anxiolytic drug;
beta-adrenergic antagonist;
environmental contaminant;
human blood serum metabolite;
vasodilator agent;
xenobiotic
rolipram
[no description available]		7.7830pyrrolidin-2-onesantidepressant;
EC 3.1.4.* (phosphoric diester hydrolase) inhibitor
tetraethylammonium
Tetraethylammonium: A potassium-selective ion channel blocker. (From J Gen Phys 1994;104(1):173-90)		2.0110quaternary ammonium ion
vesnarinone
[no description available]		4.0420organic molecular entity
corticosterone
[no description available]		2.11011beta-hydroxy steroid;
20-oxo steroid;
21-hydroxy steroid;
3-oxo-Delta(4) steroid;
C21-steroid;
glucocorticoid;
primary alpha-hydroxy ketone		human metabolite;
mouse metabolite
carbachol
Carbachol: A slowly hydrolyzed CHOLINERGIC AGONIST that acts at both MUSCARINIC RECEPTORS and NICOTINIC RECEPTORS.		1.9910ammonium salt;
carbamate ester		cardiotonic drug;
miotic;
muscarinic agonist;
nicotinic acetylcholine receptor agonist;
non-narcotic analgesic
spironolactone
Spironolactone: A potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827). spironolactone : A steroid lactone that is 17alpha-pregn-4-ene-21,17-carbolactone substituted by an oxo group at position 3 and an alpha-acetylsulfanyl group at position 7.		3.12103-oxo-Delta(4) steroid;
oxaspiro compound;
steroid lactone;
thioester		aldosterone antagonist;
antihypertensive agent;
diuretic;
environmental contaminant;
xenobiotic
etiocholanolone
Etiocholanolone: The 5-beta-reduced isomer of ANDROSTERONE. Etiocholanolone is a major metabolite of TESTOSTERONE and ANDROSTENEDIONE in many mammalian species including humans. It is excreted in the URINE.. 3alpha-hydroxy-5beta-androstan-17-one : An androstanoid that is 5beta-androstane substituted by an alpha-hydroxy group at position 3 and an oxo group at position 17. It is a metabolite of testosterone in mammals.		4.914017-oxo steroid;
3alpha-hydroxy steroid;
androstanoid		human metabolite;
mouse metabolite
pentylenetetrazole
Pentylenetetrazole: A pharmaceutical agent that displays activity as a central nervous system and respiratory stimulant. It is considered a non-competitive GAMMA-AMINOBUTYRIC ACID antagonist. Pentylenetetrazole has been used experimentally to study seizure phenomenon and to identify pharmaceuticals that may control seizure susceptibility.. pentetrazol : An organic heterobicyclic compound that is 1H-tetrazole in which the hydrogens at positions 1 and 5 are replaced by a pentane-1,5-diyl group. A central and respiratory stimulant, it was formerly used for the treatment of cough and other respiratory tract disorders, cardiovascular disorders including hypotension, and pruritis.		2.1510organic heterobicyclic compound;
organonitrogen heterocyclic compound
apomorphine
Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use.		2.2510aporphine alkaloidalpha-adrenergic drug;
antidyskinesia agent;
antiparkinson drug;
dopamine agonist;
emetic;
serotonergic drug
adenosine diphosphate
Adenosine Diphosphate: Adenosine 5'-(trihydrogen diphosphate). An adenine nucleotide containing two phosphate groups esterified to the sugar moiety at the 5'-position.		3.3220adenosine 5'-phosphate;
purine ribonucleoside 5'-diphosphate		fundamental metabolite;
human metabolite
carbostyril
Quinolones: A group of derivatives of naphthyridine carboxylic acid, quinoline carboxylic acid, or NALIDIXIC ACID.. quinolin-2(1H)-one : A quinolone that is 1,2-dihydroquinoline substituted by an oxo group at position 2.		3.5420monohydroxyquinoline;
quinolone		bacterial xenobiotic metabolite
phenylephrine
Phenylephrine: An alpha-1 adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent.. phenylephrine : A member of the class of the class of phenylethanolamines that is (1R)-2-(methylamino)-1-phenylethan-1-ol carrying an additional hydroxy substituent at position 3 on the phenyl ring.		2.0310phenols;
phenylethanolamines;
secondary amino compound		alpha-adrenergic agonist;
cardiotonic drug;
mydriatic agent;
nasal decongestant;
protective agent;
sympathomimetic agent;
vasoconstrictor agent
tyrosine
Tyrosine: A non-essential amino acid. In animals it is synthesized from PHENYLALANINE. It is also the precursor of EPINEPHRINE; THYROID HORMONES; and melanin.. tyrosine : An alpha-amino acid that is phenylalanine bearing a hydroxy substituent at position 4 on the phenyl ring.		3.4211amino acid zwitterion;
erythrose 4-phosphate/phosphoenolpyruvate family amino acid;
L-alpha-amino acid;
proteinogenic amino acid;
tyrosine		EC 1.3.1.43 (arogenate dehydrogenase) inhibitor;
fundamental metabolite;
micronutrient;
nutraceutical
methacholine chloride
Methacholine Chloride: A quaternary ammonium parasympathomimetic agent with the muscarinic actions of ACETYLCHOLINE. It is hydrolyzed by ACETYLCHOLINESTERASE at a considerably slower rate than ACETYLCHOLINE and is more resistant to hydrolysis by nonspecific CHOLINESTERASES so that its actions are more prolonged. It is used as a parasympathomimetic bronchoconstrictor agent and as a diagnostic aid for bronchial asthma. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1116)		2.1510quaternary ammonium salt
mannitol
[no description available]		2.4920mannitolallergen;
antiglaucoma drug;
compatible osmolytes;
Escherichia coli metabolite;
food anticaking agent;
food bulking agent;
food humectant;
food stabiliser;
food thickening agent;
hapten;
metabolite;
osmotic diuretic;
sweetening agent
histidine
Histidine: An essential amino acid that is required for the production of HISTAMINE.. L-histidine : The L-enantiomer of the amino acid histidine.. histidine : An alpha-amino acid that is propanoic acid bearing an amino substituent at position 2 and a 1H-imidazol-4-yl group at position 3.		2.110amino acid zwitterion;
histidine;
L-alpha-amino acid;
polar amino acid zwitterion;
proteinogenic amino acid		algal metabolite;
Escherichia coli metabolite;
human metabolite;
micronutrient;
mouse metabolite;
nutraceutical;
Saccharomyces cerevisiae metabolite
valine
Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway.. valine : A branched-chain amino acid that consists of glycine in which one of the hydrogens attached to the alpha-carbon is substituted by an isopropyl group.. L-valine : The L-enantiomer of valine.		2.0610L-alpha-amino acid zwitterion;
L-alpha-amino acid;
proteinogenic amino acid;
pyruvate family amino acid;
valine		algal metabolite;
Escherichia coli metabolite;
human metabolite;
micronutrient;
mouse metabolite;
nutraceutical;
Saccharomyces cerevisiae metabolite
acetonitrile
acetonitrile: RN given refers to unlabeled cpd. acetonitrile : A nitrile that is hydrogen cyanide in which the hydrogen has been replaced by a methyl group.		2.2510aliphatic nitrile;
volatile organic compound		EC 3.5.1.4 (amidase) inhibitor;
NMR chemical shift reference compound;
polar aprotic solvent
methylprednisolone
Methylprednisolone: A PREDNISOLONE derivative with similar anti-inflammatory action.. 6alpha-methylprednisolone : The 6alpha-stereoisomer of 6-methylprednisolone.		3.27106-methylprednisolone;
primary alpha-hydroxy ketone;
tertiary alpha-hydroxy ketone		adrenergic agent;
anti-inflammatory drug;
antiemetic;
environmental contaminant;
neuroprotective agent;
xenobiotic
isosorbide dinitrate
Isosorbide Dinitrate: A vasodilator used in the treatment of ANGINA PECTORIS. Its actions are similar to NITROGLYCERIN but with a slower onset of action.		3.1310glucitol derivative;
nitrate ester		nitric oxide donor;
vasodilator agent
pyrroles
1H-pyrrole : A tautomer of pyrrole that has the double bonds at positions 2 and 4.. pyrrole : A five-membered monocyclic heteroarene comprising one NH and four CH units which forms the parent compound of the pyrrole group of compounds. Its five-membered ring structure has three tautomers. A 'closed class'.. azole : Any monocyclic heteroarene consisting of a five-membered ring containing nitrogen. Azoles can also contain one or more other non-carbon atoms, such as nitrogen, sulfur or oxygen.		1.9910pyrrole;
secondary amine
catechin
Catechin: An antioxidant flavonoid, occurring especially in woody plants as both (+)-catechin and (-)-epicatechin (cis) forms.. catechin : Members of the class of hydroxyflavan that have a flavan-3-ol skeleton and its substituted derivatives.. rac-catechin : A racemate comprising equimolar amounts of (+)- and (-)-catechin. (+)-catechin : The (+)-enantiomer of catechin and a polyphenolic antioxidant plant metabolite.		2.3110catechinantioxidant;
plant metabolite
pyrazines
Pyrazines: A heterocyclic aromatic organic compound with the chemical formula C4H4N2.. pyrazine : A diazine that is benzene in which the carbon atoms at positions 1 and 4 have been replaced by nitrogen atoms.		4.0420diazine;
pyrazines		Daphnia magna metabolite
thymoquinone
thymoquinone: constituent of cedarwood; can cause dermatitis; structure. thymoquinone : A member of the class of 1,4-benzoquinones that is 1,4-bezoquinone in which the hydrogens at positions 2 and 5 are replaced by methyl and isopropyl groups, respectively. It is a natural compound isolated from Nigella sativa which has demonstrated promising chemotherapeutic activity.		7.17101,4-benzoquinonesadjuvant;
anti-inflammatory agent;
antidepressant;
antineoplastic agent;
antioxidant;
cardioprotective agent;
plant metabolite
alpha-aminopyridine
alpha-aminopyridine: RN given refers to parent cpd; structure in Merck Index, 9th ed, #485. aminopyridine : Compounds containing a pyridine skeleton substituted by one or more amine groups.		2.1110
malondialdehyde
Malondialdehyde: The dialdehyde of malonic acid.. malonaldehyde : A dialdehyde that is propane substituted by two oxo groups at the terminal carbon atoms respectively. A biomarker of oxidative damage to lipids caused by smoking, it exists in vivo mainly in the enol form.		7.31143dialdehydebiomarker
acetylcysteine
N-acetyl-L-cysteine : An N-acetyl-L-amino acid that is the N-acetylated derivative of the natural amino acid L-cysteine.		7.3110acetylcysteine;
L-cysteine derivative;
N-acetyl-L-amino acid		antidote to paracetamol poisoning;
antiinfective agent;
antioxidant;
antiviral drug;
ferroptosis inhibitor;
geroprotector;
human metabolite;
mucolytic;
radical scavenger;
vulnerary
xenon
Xenon: A noble gas with the atomic symbol Xe, atomic number 54, and atomic weight 131.30. It is found in the earth's atmosphere and has been used as an anesthetic.		7.110monoatomic xenon;
noble gas atom;
p-block element atom
magnesium sulfate
Magnesium Sulfate: A small colorless crystal used as an anticonvulsant, a cathartic, and an electrolyte replenisher in the treatment of pre-eclampsia and eclampsia. It causes direct inhibition of action potentials in myometrial muscle cells. Excitation and contraction are uncoupled, which decreases the frequency and force of contractions. (From AMA Drug Evaluations Annual, 1992, p1083). magnesium sulfate : A magnesium salt having sulfate as the counterion.		2.2110magnesium salt;
metal sulfate;
organic magnesium salt		anaesthetic;
analgesic;
anti-arrhythmia drug;
anticonvulsant;
calcium channel blocker;
cardiovascular drug;
fertilizer;
tocolytic agent
phosphine
phosphane : The simplest phosphine, consisting of a single phosphorus atom with three hydrogens attached.. phosphine : Phosphane (PH3) and compounds derived from it by substituting one, two or three hydrogen atoms by hydrocarbyl groups: RPH2, R2PH, R3P (R =/= H) are called primary, secondary and tertiary phosphines, respectively. A specific phosphine is preferably named as a substituted phosphane.		2.7620mononuclear parent hydride;
phosphanes;
phosphine		carcinogenic agent;
fumigant insecticide
thallium chloride
thallium chloride: RN given refers to unlabeled parent cpd		2.0310inorganic chloride;
thallium molecular entity
bromocriptine
Bromocriptine: A semisynthetic ergotamine alkaloid that is a dopamine D2 agonist. It suppresses prolactin secretion.		3.2110indole alkaloidantidyskinesia agent;
antiparkinson drug;
dopamine agonist;
hormone antagonist
dobutamine
Dobutamine: A catecholamine derivative with specificity for BETA-1 ADRENERGIC RECEPTORS. It is commonly used as a cardiotonic agent after CARDIAC SURGERY and during DOBUTAMINE STRESS ECHOCARDIOGRAPHY.. dobutamine : A catecholamine that is 4-(3-aminobutyl)phenol in which one of the hydrogens attached to the nitrogen is substituted by a 2-(3,4-dihydroxyphenyl)ethyl group. A beta1-adrenergic receptor agonist that has cardiac stimulant action without evoking vasoconstriction or tachycardia, it is used as the hydrochloride to increase the contractility of the heart in the management of acute heart failure.		19.0315655catecholamine;
secondary amine		beta-adrenergic agonist;
cardiotonic drug;
sympathomimetic agent
ng-nitroarginine methyl ester
NG-Nitroarginine Methyl Ester: A non-selective inhibitor of nitric oxide synthase. It has been used experimentally to induce hypertension.		4.2450alpha-amino acid ester;
L-arginine derivative;
methyl ester;
N-nitro compound		EC 1.14.13.39 (nitric oxide synthase) inhibitor
captopril
Captopril: A potent and specific inhibitor of PEPTIDYL-DIPEPTIDASE A. It blocks the conversion of ANGIOTENSIN I to ANGIOTENSIN II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the RENIN-ANGIOTENSIN SYSTEM and inhibits pressure responses to exogenous angiotensin.. captopril : A L-proline derivative in which L-proline is substituted on nitrogen with a (2S)-2-methyl-3-sulfanylpropanoyl group. It is used as an anti-hypertensive ACE inhibitor drug.		8.3711alkanethiol;
L-proline derivative;
N-acylpyrrolidine;
pyrrolidinemonocarboxylic acid		antihypertensive agent;
EC 3.4.15.1 (peptidyl-dipeptidase A) inhibitor
nicorandil
Nicorandil: A derivative of the NIACINAMIDE that is structurally combined with an organic nitrate. It is a potassium-channel opener that causes vasodilatation of arterioles and large coronary arteries. Its nitrate-like properties produce venous vasodilation through stimulation of guanylate cyclase.. nicorandil : A pyrimidinecarboxamide that is nicotinamide in which one of the hydrogens attached to the carboxamide nitrogen is replaced by a 2-(nitrooxy)ethyl group. It has both nitrate-like and ATP-sensitive potassium channel activator properties, and is used for the prevention and treatment of angina pectoris.		4.9221nitrate ester;
pyridinecarboxamide		potassium channel opener;
vasodilator agent
colforsin
Colforsin: Potent activator of the adenylate cyclase system and the biosynthesis of cyclic AMP. From the plant COLEUS FORSKOHLII. Has antihypertensive, positive inotropic, platelet aggregation inhibitory, and smooth muscle relaxant activities; also lowers intraocular pressure and promotes release of hormones from the pituitary gland.		2.4110acetate ester;
cyclic ketone;
labdane diterpenoid;
organic heterotricyclic compound;
tertiary alpha-hydroxy ketone;
triol		adenylate cyclase agonist;
anti-HIV agent;
antihypertensive agent;
plant metabolite;
platelet aggregation inhibitor;
protein kinase A agonist
enoximone
Enoximone: A selective phosphodiesterase inhibitor with vasodilating and positive inotropic activity that does not cause changes in myocardial oxygen consumption. It is used in patients with CONGESTIVE HEART FAILURE.		9.61142aromatic ketone
simvastatin
Simvastatin: A derivative of LOVASTATIN and potent competitive inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HYDROXYMETHYLGLUTARYL COA REDUCTASES), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL RECEPTORS, it increases breakdown of LDL CHOLESTEROL.. simvastatin : A member of the class of hexahydronaphthalenes that is lovastatin in which the 2-methylbutyrate ester moiety has been replaced by a 2,2-dimethylbutyrate ester group. It is used as a cholesterol-lowering and anti-cardiovascular disease drug.		2.2110delta-lactone;
fatty acid ester;
hexahydronaphthalenes;
statin (semi-synthetic)		EC 1.1.1.34/EC 1.1.1.88 (hydroxymethylglutaryl-CoA reductase) inhibitor;
EC 3.4.24.83 (anthrax lethal factor endopeptidase) inhibitor;
ferroptosis inducer;
geroprotector;
prodrug
itraconazole
Itraconazole: A triazole antifungal agent that inhibits cytochrome P-450-dependent enzymes required for ERGOSTEROL synthesis.. itraconazole : An N-arylpiperazine that is cis-ketoconazole in which the imidazol-1-yl group is replaced by a 1,2,4-triazol-1-yl group and in which the actyl group attached to the piperazine moiety is replaced by a p-[(+-)1-sec-butyl-5-oxo-1,5-dihydro-4H-1,2,4-triazol-4-yl]phenyl group. A potent P-glycoprotein and CYP3A4 inhibitor, it is used as an antifungal drug for the treatment of various fungal infections, including aspergillosis, blastomycosis, candidiasis, chromoblastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, and sporotrichosis.		3.3811aromatic ether;
conazole antifungal drug;
cyclic ketal;
dichlorobenzene;
dioxolane;
N-arylpiperazine;
triazole antifungal drug;
triazoles		EC 3.6.3.44 (xenobiotic-transporting ATPase) inhibitor;
Hedgehog signaling pathway inhibitor;
P450 inhibitor
ranolazine
Ranolazine: An acetanilide and piperazine derivative that functions as a SODIUM CHANNEL BLOCKER and prevents the release of enzymes during MYOCARDIAL ISCHEMIA. It is used in the treatment of ANGINA PECTORIS.. N-(2,6-dimethylphenyl)-2-{4-[2-hydroxy-3-(2-methoxyphenoxy)propyl]piperazin-1-yl}acetamide : An aromatic amide obtained by formal condensation of the carboxy group of 2-{4-[2-hydroxy-3-(2-methoxyphenoxy)propyl]piperazin-1-yl}acetic acid with the amino group of 2,6-dimethylaniline.. ranolazine : A racemate comprising equal amounts of (R)- and (S)-ranolazine. Used for treatment of chronic angina.		7.1710aromatic amide;
monocarboxylic acid amide;
monomethoxybenzene;
N-alkylpiperazine;
secondary alcohol
fura-2
Fura-2: A fluorescent calcium chelating agent which is used to study intracellular calcium in tissues.		2.0110
esmolol
methyl 3-{4-[2-hydroxy-3-(propan-2-ylamino)propoxy]phenyl}propanoate : A methyl ester that is methyl 3-(4-hydroxyphenyl)propanoate in which the hydrogen attached to the phenolic hydroxy group is substituted by a 2-hydroxy-3-(isopropylamino)propyl group.. esmolol : A racemate comprising equimolar amounts of (R)- and (S)-esmolol. A cardioselective and short-acting beta1 receptor blocker with rapid onset but lacking intrinsic sympathomimetic and membrane-stabilising properties, it is used as the hydrochloride salt in the management of supraventricular arrhythmias, and for the control of hypertension and tachycardia during surgery. While the S enantiomer possesses all of the heart rate control, both enantiomers contribute to lowering blood pressure.		7.4420aromatic ether;
ethanolamines;
methyl ester;
secondary alcohol;
secondary amino compound
toborinone
toborinone: structure given in first source		3.110quinolines
valsartan
Valsartan: A tetrazole derivative and ANGIOTENSIN II TYPE 1 RECEPTOR BLOCKER that is used to treat HYPERTENSION.. valsartan : A monocarboxylic acid amide consisting of L-valine in which the amino hydrogens have been replaced by a pentanoyl and a [2'-(1H-tetrazol-5-yl)biphenyl]-4-yl]methyl group. It exhibits antihypertensive activity.		3.0840biphenylyltetrazole;
monocarboxylic acid amide;
monocarboxylic acid		angiotensin receptor antagonist;
antihypertensive agent;
environmental contaminant;
xenobiotic
adenosine
quinquefolan B: isolated from roots of Panax quinquefolium L.; RN not in Chemline 10/87; RN from Toxlit		4.3530adenosines;
purines D-ribonucleoside		analgesic;
anti-arrhythmia drug;
fundamental metabolite;
human metabolite;
vasodilator agent
rolofylline
rolofylline: selective antagonist for adenosine receptors; a cardiovascular agent		3.1810oxopurine
epigallocatechin gallate
epigallocatechin gallate: a steroid 5alpha-reductase inhibitor and antimutagen in green tea (Camellia sinensis). (-)-epigallocatechin 3-gallate : A gallate ester obtained by the formal condensation of gallic acid with the (3R)-hydroxy group of (-)-epigallocatechin.		2.3110flavans;
gallate ester;
polyphenol		antineoplastic agent;
antioxidant;
apoptosis inducer;
geroprotector;
Hsp90 inhibitor;
neuroprotective agent;
plant metabolite
glutathione disulfide
Glutathione Disulfide: A GLUTATHIONE dimer formed by a disulfide bond between the cysteine sulfhydryl side chains during the course of being oxidized.		2.1710glutathione derivative;
organic disulfide		Escherichia coli metabolite;
mouse metabolite
zatebradine
[no description available]		6.9810benzazepine
cromakalim
Cromakalim: A potassium-channel opening vasodilator that has been investigated in the management of hypertension. It has also been tried in patients with asthma. (Martindale, The Extra Pharmacopoeia, 30th ed, p352)		7.9340
homocysteine
Homocysteine: A thiol-containing amino acid formed by a demethylation of METHIONINE.. homocysteine : A sulfur-containing amino acid consisting of a glycine core with a 2-mercaptoethyl side-chain.. L-homocysteine : A homocysteine that has L configuration.		7.1710amino acid zwitterion;
homocysteine;
serine family amino acid		fundamental metabolite;
mouse metabolite
2-phenyl-5,5-dimethyltetrahydro-1,4-oxazine
2-phenyl-5,5-dimethyltetrahydro-1,4-oxazine: anorectic; CNS stimulant; synonym G 130 refers to HCl; RN given refers to parent cpd; structure		4.411
bosentan anhydrous
Bosentan: A sulfonamide and pyrimidine derivative that acts as a dual endothelin receptor antagonist used to manage PULMONARY HYPERTENSION and SYSTEMIC SCLEROSIS.		3.110primary alcohol;
pyrimidines;
sulfonamide		antihypertensive agent;
endothelin receptor antagonist
paxilline
paxilline: structure given in first source; RN given refers to (2R-(2alpha,4bbeta,6aalpha,12bbeta,12calpha,14abeta))-isomer. paxilline : An indole diterpene alkaloid with formula C27H33NO4 isolated from Penicillium paxilli. It is a potent inhibitor of large conductance Ca2(+)- and voltage-activated K(+) (BK)-type channels.		2.1710diterpene alkaloid;
enone;
organic heterohexacyclic compound;
terpenoid indole alkaloid;
tertiary alcohol		anticonvulsant;
Aspergillus metabolite;
EC 3.6.3.8 (Ca(2+)-transporting ATPase) inhibitor;
genotoxin;
geroprotector;
mycotoxin;
Penicillium metabolite;
potassium channel blocker
indo-1
indo-1: structure given in first source		6.9910indolesfluorochrome
kt 5823
KT 5823: indolocarbazole; activates human neutrophils & fails to inhibit cGMP-dependent protein kinase phosphorylation of vimentin. KT 5823 : An organic heterooctacyclic compound that is 1H,1'H-2,2'-biindole in which the nitrogens have undergone formal oxidative coupling to positions 2 and 5 of methyl (3R)-3-methoxy-2-methyltetrahydrofuran-3-carboxylate (the 2S,3R,5R product), and in which the 3 and 3' positions of the biindole moiety have also undergone formal oxidative coupling to positions 3 and 4 of 1-methyl-1,5-dihydro-2H-pyrrol-2-one.		1.9910gamma-lactam;
hemiaminal;
indolocarbazole;
methyl ester;
organic heterooctacyclic compound		EC 2.7.11.12 (cGMP-dependent protein kinase) inhibitor
landiolol
landiolol: structure given in first source; a highly cardioselective ultra short-acting beta-blocker		7.2510morpholines
mci 154
MCI 154: structure given in UD 38:41n		5.0450
ivabradine
Ivabradine: A benzazepine derivative and selective HYPERPOLARIZATION-ACTIVATED CYCLIC NUCLEOTIDE-GATED CHANNELS inhibitor that lowers the heart rate. It is used in the treatment of CHRONIC STABLE ANGINA in patients unable to take BETA-ADRENERGIC BLOCKERS, and in the treatment of HEART FAILURE.. ivabradine : A member of the class of benzazepines that is 7,8-dimethoxy-1,3,4,5-tetrahydro-3-benzazepin-2-one in which the amide hydrogen is replaced by a [{[(7S)-3,4-dimethoxybicyclo[4.2.0]octa-1,3,5-trien-7-yl]methyl}(methyl)amino]propyl} group. Used (as its hydrochloride salt) to treat patients with angina who have intolerance to beta blockers and/or heart failure.		3.4411aromatic ether;
benzazepine;
carbobicyclic compound;
tertiary amino compound		cardiotonic drug
ba 41899
BA 41899: a 1,5-benzodiazocine derivative; a positive inotropic Ca(2+)-sensitizing agent; CGP-48506 is the (+)-isomer; CGP-48508 is the (-)-isomer; structure given in first source		3.5220
ezetimibe
Ezetimibe: An azetidine derivative and ANTICHOLESTEREMIC AGENT that inhibits intestinal STEROL absorption. It is used to reduce total CHOLESTEROL; LDL CHOLESTEROL, and APOLIPOPROTEINS B in the treatment of HYPERLIPIDEMIAS.. ezetimibe : A beta-lactam that is azetidin-2-one which is substituted at 1, 3, and 4 by p-fluorophenyl, 3-(p-fluorophenyl)-3-hydroxypropyl, and 4-hydroxyphenyl groups, respectively (the 3R,3'S,4S enantiomer).		3.1110azetidines;
beta-lactam;
organofluorine compound		anticholesteremic drug;
antilipemic drug;
antimetabolite
cariporide
cariporide: a selective sodium-hydrogen exchange subtype 1 inhibitor; structure in first source		7.0410
tezosentan
tezosentan: structure in first source		6.3680
clevidipine
clevidipine: a calcium channel blocker and antihypertensive agent; structure in first source		3.1510dihydropyridine
angiotensin ii
Giapreza: injectable form of angiotensin II used to increase blood pressure in adult patients with septic or other distributive shock. Ile(5)-angiotensin II : An angiotensin II that acts on the central nervous system (PDB entry: 1N9V).		9.3930amino acid zwitterion;
angiotensin II		human metabolite
ropivacaine
Ropivacaine: An anilide used as a long-acting local anesthetic. It has a differential blocking effect on sensory and motor neurons.. ropivacaine : The piperidinecarboxamide obtained by the formal condensation of N-propylpipecolic acid and 2,6-dimethylaniline.. (S)-ropivacaine : A piperidinecarboxamide-based amide-type local anaesthetic (amide caine) in which (S)-N-propylpipecolic acid and 2,6-dimethylaniline are combined to form the amide bond.		7.0310piperidinecarboxamide;
ropivacaine		local anaesthetic
emd 53998
EMD 53998: EMD 53998 is racemic; EMD 57439 is the (-)-isomer; EMD 57033 is the (+)-isomer		5.99110
tolvaptan
[no description available]		5.1740benzazepine;
benzenedicarboxamide		aquaretic;
vasopressin receptor antagonist
3-nitrotyrosine
3-nitrotyrosine: RN given refers to parent cpd without isomeric designation. 3-nitrotyrosine : A nitrotyrosine comprising tyrosine having a nitro group at the 3-position on the phenyl ring.		3.42112-nitrophenols;
C-nitro compound;
nitrotyrosine;
non-proteinogenic alpha-amino acid
6-phenyl-4,5-dihydro-3(2h)-pyridazinone
6-phenyl-4,5-dihydro-3(2H)-pyridazinone: structure in first source		2.0310pyridazines
dihydropyridines
Dihydropyridines: Pyridine moieties which are partially saturated by the addition of two hydrogen atoms in any position.		4.0320
oxytocin
Oxytocin: A nonapeptide hormone released from the neurohypophysis (PITUITARY GLAND, POSTERIOR). It differs from VASOPRESSIN by two amino acids at residues 3 and 8. Oxytocin acts on SMOOTH MUSCLE CELLS, such as causing UTERINE CONTRACTIONS and MILK EJECTION.. oxytocin : A cyclic nonapeptide hormone with amino acid sequence CYIQNCPLG that also acts as a neurotransmitter in the brain; the principal uterine-contracting and milk-ejecting hormone of the posterior pituitary. Together with the neuropeptide vasopressin, it is believed to influence social cognition and behaviour.		2.0510heterodetic cyclic peptide;
peptide hormone		oxytocic;
vasodilator agent
eplerenone
Eplerenone: A spironolactone derivative and selective ALDOSTERONE RECEPTOR antagonist that is used in the management of HYPERTENSION and CONGESTIVE HEART FAILURE, post-MYOCARDIAL INFARCTION.		3.12103-oxo-Delta(4) steroid;
epoxy steroid;
gamma-lactone;
methyl ester;
organic heteropentacyclic compound;
oxaspiro compound;
steroid acid ester		aldosterone antagonist;
antihypertensive agent
betadex
beta-Cyclodextrins: Cyclic GLUCANS consisting of seven (7) glucopyranose units linked by 1,4-glycosidic bonds.		2.0210cyclodextrin
kt 5720
KT 5720: indolocarbazole; synthetic derivative of K 252a. KT 5720 : An organic heterooctacyclic compound that is 1H,1'H-2,2'-biindole in which the nitrogens have undergone formal oxidative coupling to positions 2 and 5 of hexyl (3S)-3-hydroxy-2-methyltetrahydrofuran-3-carboxylate (the 2R,3S,5S product), and in which the 3 and 3' positions of the biindole moiety have also undergone formal oxidative coupling to positions 3 and 4 of 1,5-dihydro-2H-pyrrol-2-one.		1.9910carboxylic ester;
gamma-lactam;
hemiaminal;
indolocarbazole;
organic heterooctacyclic compound;
semisynthetic derivative;
tertiary alcohol		EC 2.7.11.11 (cAMP-dependent protein kinase) inhibitor
arginine vasopressin
Arginine Vasopressin: The predominant form of mammalian antidiuretic hormone. It is a nonapeptide containing an ARGININE at residue 8 and two disulfide-linked cysteines at residues of 1 and 6. Arg-vasopressin is used to treat DIABETES INSIPIDUS or to improve vasomotor tone and BLOOD PRESSURE.. argipressin : The predominant form of mammalian vasopressin (antidiuretic hormone). It is a nonapeptide containing an arginine at residue 8 and two disulfide-linked cysteines at residues of 1 and 6.		4.4160vasopressincardiovascular drug;
hematologic agent;
mitogen
digoxin
Digoxin: A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666). digoxin : A cardenolide glycoside that is digitoxin beta-hydroxylated at C-12. A cardiac glycoside extracted from the foxglove plant, Digitalis lanata, it is used to control ventricular rate in atrial fibrillation and in the management of congestive heart failure with atrial fibrillation, but the margin between toxic and therapeutic doses is small.		11.4672cardenolide glycoside;
steroid saponin		anti-arrhythmia drug;
cardiotonic drug;
EC 3.6.3.9 (Na(+)/K(+)-transporting ATPase) inhibitor;
epitope
ovalbumin
Ovalbumin: An albumin obtained from the white of eggs. It is a member of the serpin superfamily.		2.0310
dinoprost
Dinoprost: A naturally occurring prostaglandin that has oxytocic, luteolytic, and abortifacient activities. Due to its vasocontractile properties, the compound has a variety of other biological actions.. prostaglandin F2alpha : A prostaglandins Falpha that is prosta-5,13-dien-1-oic acid substituted by hydroxy groups at positions 9, 11 and 15. It is a naturally occurring prostaglandin used to induce labor.		2.1710monocarboxylic acid;
prostaglandins Falpha		human metabolite;
mouse metabolite
alprostadil
[no description available]		4.6732prostaglandins Eanticoagulant;
human metabolite;
platelet aggregation inhibitor;
vasodilator agent
4-hydroxy-2-nonenal
4-hydroxy-2-nonenal: cytotoxic product from peroxidation of liver microsomal lipids; RN given refers to cpd without isomeric designation. 4-hydroxynon-2-enal : An enal consisting of non-2-ene having an oxo group at the 1-position and a hydroxy group at the 4-position.. 4-hydroxynonenal : A monounsaturated fatty aldehyde that is nonanal that has undergone dehydrogenation to introduce a double bond at any position in the aliphatic chain and in which a hydrogen at position 4 has been replaced by a hydroxy group.		2.11104-hydroxynon-2-enal;
4-hydroxynonenal
dexmedetomidine
[no description available]		3.2510medetomidinealpha-adrenergic agonist;
analgesic;
non-narcotic analgesic;
sedative
iloprost
Iloprost: An eicosanoid, derived from the cyclooxygenase pathway of arachidonic acid metabolism. It is a stable and synthetic analog of EPOPROSTENOL, but with a longer half-life than the parent compound. Its actions are similar to prostacyclin. Iloprost produces vasodilation and inhibits platelet aggregation.. iloprost : A carbobicyclic compound that is prostaglandin I2 in which the endocyclic oxygen is replaced by a methylene group and in which the (1E,3S)-3-hydroxyoct-1-en-1-yl side chain is replaced by a (3R)-3-hydroxy-4-methyloct-1-en-6-yn-1-yl group. A synthetic analogue of prostacyclin, it is used as the trometamol salt (generally by intravenous infusion) for the treatment of peripheral vascular disease and pulmonary hypertension.		4.0850carbobicyclic compound;
monocarboxylic acid;
secondary alcohol		platelet aggregation inhibitor;
vasodilator agent
15-hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic acid
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid: A stable prostaglandin endoperoxide analog which serves as a thromboxane mimetic. Its actions include mimicking the hydro-osmotic effect of VASOPRESSIN and activation of TYPE C PHOSPHOLIPASES. (From J Pharmacol Exp Ther 1983;224(1): 108-117; Biochem J 1984;222(1):103-110)		2.0110
thallium
Thallium: A heavy, bluish white metal, atomic number 81, atomic weight [204.382; 204.385], symbol Tl.. thallium : A metallic element first identified and named from the brilliant green line in its flame spectrum (from Greek thetaalphalambdalambdaomicronsigma, a green shoot).		2.0310boron group element atom
ramipril
Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat.. ramipril : A dipeptide that is the prodrug for ramiprilat, the active metabolite obtained by hydrolysis of the ethyl ester group. An angiotensin-converting enzyme (ACE) inhibitor, used to treat high blood pressure and congestive heart failure.. quark : Quarks comprise one of two classes of the fundamental particles. Quarks possess fractional electric charges and are not observed in free state. The word "quark" first appears in James Joyce's Finnegans Wake and has been chosen by Murray Gell-Mann as a name for fundamental building blocks of particles.		7.6320azabicycloalkane;
cyclopentapyrrole;
dicarboxylic acid monoester;
dipeptide;
ethyl ester		bradykinin receptor B2 agonist;
cardioprotective agent;
EC 3.4.15.1 (peptidyl-dipeptidase A) inhibitor;
matrix metalloproteinase inhibitor;
prodrug
enalapril
Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat HYPERTENSION and HEART FAILURE.. enalapril : A dicarboxylic acid monoester that is ethyl 4-phenylbutanoate in which a hydrogen alpha to the carboxy group is substituted by the amino group of L-alanyl-L-proline (S-configuration).		210dicarboxylic acid monoester;
dipeptide		antihypertensive agent;
EC 3.4.15.1 (peptidyl-dipeptidase A) inhibitor;
geroprotector;
prodrug
fumarates
Fumarates: Compounds based on fumaric acid.. fumarate(2-) : A C4-dicarboxylate that is the E-isomer of but-2-enedioate(2-)		3.1910butenedioate;
C4-dicarboxylate		human metabolite;
metabolite;
Saccharomyces cerevisiae metabolite
cysteine
Cysteine: A thiol-containing non-essential amino acid that is oxidized to form CYSTINE.. L-cysteinium : The L-enantiomer of cysteinium.. cysteine : A sulfur-containing amino acid that is propanoic acid with an amino group at position 2 and a sulfanyl group at position 3.		2.4620cysteiniumfundamental metabolite
phosphorus
Phosphorus: A non-metal element that has the atomic symbol P, atomic number 15, and atomic weight 31. It is an essential element that takes part in a broad variety of biochemical reactions.		2.9310monoatomic phosphorus;
nonmetal atom;
pnictogen		macronutrient
enalaprilat anhydrous
Enalaprilat: The active metabolite of ENALAPRIL and one of the potent, intravenously administered, ANGIOTENSIN-CONVERTING ENZYME INHIBITORS. It is an effective agent for the treatment of essential hypertension and has beneficial hemodynamic effects in heart failure. The drug produces renal vasodilation with an increase in sodium excretion.. enalaprilat dihydrate : The dihydrate form of enalaprilat, an angiotensin-converting enzyme (ACE) inhibitor that is used (often in the form of its prodrug, enalapril) in the treatment of hypertension and heart failure, for reduction of proteinuria and renal disease in patients with nephropathies, and for the prevention of stroke, myocardial infarction, and cardiac death in high-risk patients. Unlike enalapril, enalaprilat is not absorbed by mouth but is administered by intravenous injection.. enalaprilat (anhydrous) : Enalapril in which the ethyl ester group has been hydrolysed to the corresponding carboxylic acid. Enalaprilat is an angiotensin-converting enzyme (ACE) inhibitor and is used (often in the form of its prodrug, enalapril) in the treatment of hypertension and heart failure, for reduction of proteinuria and renal disease in patients with nephropathies, and for the prevention of stroke, myocardial infarction, and cardiac death in high-risk patients. Unlike enalapril, enalaprilat is not absorbed by mouth but is given by intravenous injection, usually as the dihydrate.		4.0310dicarboxylic acid;
dipeptide		antihypertensive agent;
EC 3.4.15.1 (peptidyl-dipeptidase A) inhibitor
aliskiren
aliskiren: orally active nonpeptidic renin inhibitor. aliskiren : A monomethoxybenzene compound having a 3-methoxypropoxy group at the 2-position and a multi-substituted branched alkyl substituent at the 4-position.		3.1910monocarboxylic acid amide;
monomethoxybenzene		antihypertensive agent
diacetylmonoxime
diacetylmonoxime: used diagnostically for determining urea in blood; structure; myosin ATPase antagonist. diacetylmonoxime : A ketoxime obtained via formal condensation of butane-2,3-dione with hydroxylamine. It is a reversible myosin ATPase inhibitor.		2.0510
phosphocreatine
Phosphocreatine: An endogenous substance found mainly in skeletal muscle of vertebrates. It has been tried in the treatment of cardiac disorders and has been added to cardioplegic solutions. (Reynolds JEF(Ed): Martindale: The Extra Pharmacopoeia (electronic version). Micromedex, Inc, Englewood, CO, 1996). phosphagen : Any of a group of guanidine or amidine phosphates that function as storage depots for high-energy phosphate in muscle with the purpose of regenerating ATP from ADP during muscular contraction.. N-phosphocreatine : A phosphoamino acid consisting of creatine having a phospho group attached at the primary nitrogen of the guanidino group.		210phosphagen;
phosphoamino acid		human metabolite;
mouse metabolite
org 30029
ORG 30029: no other info available 3/90		2.0510
sacubitril
[no description available]		2.920biphenyls
istaroxime
Istaroxime: PST-2744 is the (E,Z)-isomer; a positive cardiac inotropic agent; structure in first source		4.9140
mocetinostat
mocetinostat: undergoing phase II clinical trials for treatment of cancer. mocetinostat : A benzamide obtained by formal condensation of the carboxy group of 4-({[4-(pyridin-3-yl)pyrimidin-2-yl]amino}methyl)benzoic acid with one of the amino groups of benzene-1,2-diamine. It is an orally active and isotype-selective HDAC inhibitor which exhibits antitumour activity (IC50 = 0.15, 0.29, 1.66 and 0.59 muM for HDAC1, HDAC2, HDAC3 and HDAC11).		2.4720aminopyrimidine;
benzamides;
pyridines;
secondary amino compound;
secondary carboxamide;
substituted aniline		antineoplastic agent;
apoptosis inducer;
autophagy inducer;
cardioprotective agent;
EC 3.5.1.98 (histone deacetylase) inhibitor;
hepatotoxic agent
n-(4-(4-methyl-6-oxo-1,4,5,6-tetrahydropyridazin-3-yl)phenyl)acetamide
N-(4-(4-methyl-6-oxo-1,4,5,6-tetrahydropyridazin-3-yl)phenyl)acetamide: a metabolite of levosimendan; structure in first source		6.89155
beta-acetyldigoxin
Acetyldigoxins: Alpha- or beta-acetyl derivatives of DIGOXIN or lanatoside C from Digitalis lanata. They are better absorbed and longer acting than digoxin and are used in congestive heart failure.		2.0610cardenolide glycoside
omecamtiv mecarbil
[no description available]		4.9660ureas
sepharose
agarose : A linear polysaccharide made up from alternating D-galactose and 3,6-anhydro-alpha-L-galactopyranose residues joined by alpha-(1->3)- and beta-(1->4)-linkages.		2.0710
indocyanine green
Indocyanine Green: A tricarbocyanine dye that is used diagnostically in liver function tests and to determine blood volume and cardiac output.		9.7321,1-diunsubstituted alkanesulfonate;
benzoindole;
cyanine dye
pituitrin
Pituitrin: A substance or extract from the neurohypophysis (PITUITARY GLAND, POSTERIOR).		7.91121
hmr 1098
HMR 1098: KATP channel blocker; structure in first source		2.110
nad
NAD(1-) : An anionic form of nicotinamide adenine dinucleotide arising from deprotonation of the two OH groups of the diphosphate moiety.		2.4220organophosphate oxoanioncofactor;
human metabolite;
hydrogen acceptor;
Saccharomyces cerevisiae metabolite
cytochrome c-t
Cytochromes c: Cytochromes of the c type that are found in eukaryotic MITOCHONDRIA. They serve as redox intermediates that accept electrons from MITOCHONDRIAL ELECTRON TRANSPORT COMPLEX III and transfer them to MITOCHONDRIAL ELECTRON TRANSPORT COMPLEX IV.		2.7730
atrial natriuretic factor
Atrial Natriuretic Factor: A potent natriuretic and vasodilatory peptide or mixture of different-sized low molecular weight PEPTIDES derived from a common precursor and secreted mainly by the HEART ATRIUM. All these peptides share a sequence of about 20 AMINO ACIDS.		7.8583polypeptide
ularitide
Ularitide: a 32-amino acid peptide derived from (95-126 residues) of ANP PROHORMONE (1-126 residues); not biologically inactivated by a peptidase from dog kidney cortex membranes		2.0310
iberiotoxin
[no description available]		2.4220
angiotensinogen
Angiotensinogen: An alpha-globulin of about 453 amino acids, depending on the species. It is produced by the liver in response to lowered blood pressure and secreted into blood circulation. Angiotensinogen is the inactive precursor of the ANGIOTENSINS produced in the body by successive enzyme cleavages. Cleavage of angiotensinogen by RENIN yields the decapeptide ANGIOTENSIN I. Further cleavage of angiotensin I (by ANGIOTENSIN CONVERTING ENZYME) yields the potent vasoconstrictor octapeptide ANGIOTENSIN II; and then, via other enzymes, other angiotensins also involved in the hemodynamic-regulating RENIN-ANGIOTENSIN SYSTEM.		2.0510
natriuretic peptide, c-type
Natriuretic Peptide, C-Type: A PEPTIDE of 22 amino acids, derived mainly from cells of VASCULAR ENDOTHELIUM. It is also found in the BRAIN, major endocrine glands, and other tissues. It shares structural homology with ATRIAL NATRIURETIC FACTOR. It has vasorelaxant activity thus is important in the regulation of vascular tone and blood flow. Several high molecular weight forms containing the 22 amino acids have been identified.		3.6920
endothelin-1
Endothelin-1: A 21-amino acid peptide produced in a variety of tissues including endothelial and vascular smooth-muscle cells, neurons and astrocytes in the central nervous system, and endometrial cells. It acts as a modulator of vasomotor tone, cell proliferation, and hormone production. (N Eng J Med 1995;333(6):356-63)		5.7431
technetium tc 99m sestamibi
Technetium Tc 99m Sestamibi: A technetium imaging agent used to reveal blood-starved cardiac tissue during a heart attack.		2.0310
cardiovascular agents
Cardiovascular Agents: Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.		11.82355
interleukin-8
Interleukin-8: A member of the CXC chemokine family that plays a role in the regulation of the acute inflammatory response. It is secreted by variety of cell types and induces CHEMOTAXIS of NEUTROPHILS and other inflammatory cells.		5.6832
natriuretic peptide, brain
Natriuretic Peptide, Brain: A PEPTIDE that is secreted by the BRAIN and the HEART ATRIA, stored mainly in cardiac ventricular MYOCARDIUM. It can cause NATRIURESIS; DIURESIS; VASODILATION; and inhibits secretion of RENIN and ALDOSTERONE. It improves heart function. It contains 32 AMINO ACIDS.		16.838934polypeptide
ascorbic acid
Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C, functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant.. L-ascorbic acid : The L-enantiomer of ascorbic acid and conjugate acid of L-ascorbate.. L-ascorbate : The L-enantiomer of ascorbate and conjugate base of L-ascorbic acid, arising from selective deprotonation of the 3-hydroxy group. Required for a range of essential metabolic reactions in all animals and plants.. vitamin C : Any member of a group of vitamers that belong to the chemical structural class called butenolides that exhibit biological activity against vitamin C deficiency in animals. The vitamers include L-ascorbic acid and its salt, ionized and oxidized forms.		3.5110ascorbic acid;
vitamin C		coenzyme;
cofactor;
flour treatment agent;
food antioxidant;
food colour retention agent;
geroprotector;
plant metabolite;
skin lightening agent
warfarin
Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.. warfarin : A racemate comprising equal amounts of (R)- and (S)-warfarin. Extensively used as both an anticoagulant drug and as a pesticide against rats and mice.. 4-hydroxy-3-(3-oxo-1-phenylbutyl)-1-benzopyran-2-one : A member of the class of coumarins that is 4-hydroxycoumarin which is substituted at position 3 by a 1-phenyl-3-oxo-1-butyl group.		8.3911benzenes;
hydroxycoumarin;
methyl ketone
charybdotoxin
[no description available]		2.4120
transforming growth factor beta
Transforming Growth Factor beta: A factor synthesized in a wide variety of tissues. It acts synergistically with TGF-alpha in inducing phenotypic transformation and can also act as a negative autocrine growth factor. TGF-beta has a potential role in embryonal development, cellular differentiation, hormone secretion, and immune function. TGF-beta is found mostly as homodimer forms of separate gene products TGF-beta1, TGF-beta2 or TGF-beta3. Heterodimers composed of TGF-beta1 and 2 (TGF-beta1.2) or of TGF-beta2 and 3 (TGF-beta2.3) have been isolated. The TGF-beta proteins are synthesized as precursor proteins.		2.1310
rome
Rome: The capital city of Italy.. (2R)-2-amino-2-(methoxymethyl)-4-(4-octylphenyl)butan-1-ol : A 2-amino-2-(methoxymethyl)-4-(4-octylphenyl)butan-1-ol that has R-configuration. It is a sphingosine kinase-2 inhibitor.		3.61202-amino-2-(methoxymethyl)-4-(4-octylphenyl)butan-1-olEC 2.7.1.91 (sphingosine kinase) inhibitor
cyclosporine
Cyclosporine: A cyclic undecapeptide from an extract of soil fungi. It is a powerful immunosupressant with a specific action on T-lymphocytes. It is used for the prophylaxis of graft rejection in organ and tissue transplantation. (From Martindale, The Extra Pharmacopoeia, 30th ed).		7.3110
thromboplastin
Thromboplastin: Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation.		2.1510
cyclic gmp
Cyclic GMP: Guanosine cyclic 3',5'-(hydrogen phosphate). A guanine nucleotide containing one phosphate group which is esterified to the sugar moiety in both the 3'- and 5'-positions. It is a cellular regulatory agent and has been described as a second messenger. Its levels increase in response to a variety of hormones, including acetylcholine, insulin, and oxytocin and it has been found to activate specific protein kinases. (From Merck Index, 11th ed). 3',5'-cyclic GMP : A 3',5'-cyclic purine nucleotide in which the purine nucleobase is specified as guanidine.		2.95403',5'-cyclic purine nucleotide;
guanyl ribonucleotide		Escherichia coli metabolite;
human metabolite;
mouse metabolite;
plant metabolite;
Saccharomyces cerevisiae metabolite
deoxyguanosine
[no description available]		2.6120purine 2'-deoxyribonucleoside;
purines 2'-deoxy-D-ribonucleoside		Escherichia coli metabolite;
human metabolite;
mouse metabolite;
Saccharomyces cerevisiae metabolite
sildenafil citrate
Sildenafil Citrate: A PHOSPHODIESTERASE TYPE-5 INHIBITOR; VASODILATOR AGENT and UROLOGICAL AGENT that is used in the treatment of ERECTILE DYSFUNCTION and PRIMARY PULMONARY HYPERTENSION.. sildenafil citrate : The citrate salt of sildenafil.		2.110citrate saltEC 3.1.4.35 (3',5'-cyclic-GMP phosphodiesterase) inhibitor;
vasodilator agent
8-hydroxy-2'-deoxyguanosine
8-Hydroxy-2'-Deoxyguanosine: Common oxidized form of deoxyguanosine in which C-8 position of guanine base has a carbonyl group.. 8-hydroxy-2'-deoxyguanosine : Guanosine substituted at the purine 8-position by a hydroxy group. It is used as a biomarker of oxidative DNA damage.		2.6120guanosinesbiomarker
ConditionIndicatedRelationship StrengthStudiesTrials
Cardiac Failure
[description not available]		023.04483127
Heart Failure
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.		023.04483127
Cardiomyopathies, Primary
[description not available]		011.08288
Cardiomyopathies
A group of diseases in which the dominant feature is the involvement of the CARDIAC MUSCLE itself. Cardiomyopathies are classified according to their predominant pathophysiological features (DILATED CARDIOMYOPATHY; HYPERTROPHIC CARDIOMYOPATHY; RESTRICTIVE CARDIOMYOPATHY) or their etiological/pathological factors (CARDIOMYOPATHY, ALCOHOLIC; ENDOCARDIAL FIBROELASTOSIS).		011.08288
ALS - Amyotrophic Lateral Sclerosis
[description not available]		08.171
Amyotrophic Lateral Sclerosis
A degenerative disorder affecting upper MOTOR NEURONS in the brain and lower motor neurons in the brain stem and SPINAL CORD. Disease onset is usually after the age of 50 and the process is usually fatal within 3 to 6 years. Clinical manifestations include progressive weakness, atrophy, FASCICULATION, hyperreflexia, DYSARTHRIA, dysphagia, and eventual paralysis of respiratory function. Pathologic features include the replacement of motor neurons with fibrous ASTROCYTES and atrophy of anterior SPINAL NERVE ROOTS and corticospinal tracts. (From Adams et al., Principles of Neurology, 6th ed, pp1089-94)		08.171
Heart Valve Diseases
Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE).		07.66106
Complication, Postoperative
[description not available]		018.199733
Postoperative Complications
Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.		018.199733
Blood Loss, Postoperative
[description not available]		05.9241
Blood Poisoning
[description not available]		011.77304
Cardiac Diseases
[description not available]		015.844027
Heart Diseases
Pathological conditions involving the HEART including its structural and functional abnormalities.		015.844027
Sepsis
Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK.		011.77304
Cardiac Output, Low
A state of subnormal or depressed cardiac output at rest or during stress. It is a characteristic of CARDIOVASCULAR DISEASES, including congenital, valvular, rheumatic, hypertensive, coronary, and cardiomyopathic. The serious form of low cardiac output is characterized by marked reduction in STROKE VOLUME, and systemic vasoconstriction resulting in cold, pale, and sometimes cyanotic extremities.		018.7511541
Shock, Cardiogenic
Shock resulting from diminution of cardiac output in heart disease.		014.197810
Right Ventricular Dysfunction
[description not available]		08.77304
Pulmonary Hypertension
[description not available]		012.21518
Hypertension, Pulmonary
Increased VASCULAR RESISTANCE in the PULMONARY CIRCULATION, usually secondary to HEART DISEASES or LUNG DISEASES.		012.21518
Angiospasm, Intracranial
[description not available]		04.4670
Hemorrhage, Subarachnoid
[description not available]		05.75110
Subarachnoid Hemorrhage
Bleeding into the intracranial or spinal SUBARACHNOID SPACE, most resulting from INTRACRANIAL ANEURYSM rupture. It can occur after traumatic injuries (SUBARACHNOID HEMORRHAGE, TRAUMATIC). Clinical features include HEADACHE; NAUSEA; VOMITING, nuchal rigidity, variable neurological deficits and reduced mental status.		05.75110
Vasospasm, Intracranial
Constriction of arteries in the SKULL due to sudden, sharp, and often persistent smooth muscle contraction in blood vessels. Intracranial vasospasm results in reduced vessel lumen caliber, restricted blood flow to the brain, and BRAIN ISCHEMIA that may lead to hypoxic-ischemic brain injury (HYPOXIA-ISCHEMIA, BRAIN).		04.4670
Endotoxin Shock
[description not available]		013.965915
Shock, Septic
Sepsis associated with HYPOTENSION or hypoperfusion despite adequate fluid resuscitation. Perfusion abnormalities may include but are not limited to LACTIC ACIDOSIS; OLIGURIA; or acute alteration in mental status.		013.965915
Cardiovascular Diseases
Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.		012.34192
Cardiovascular Stroke
[description not available]		016.478016
Myocardial Infarction
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).		016.478016
Cardio-Renal Syndrome
Condition where a primary dysfunction of either heart or kidney results in failure of the other organ (e.g., HEART FAILURE with worsening RENAL INSUFFICIENCY).		08.2672
Cirrhosis
[description not available]		02.8830
Innate Inflammatory Response
[description not available]		06.18111
Injury, Ischemia-Reperfusion
[description not available]		05.03140
Fibrosis
Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.		02.8830
Inflammation
A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function.		06.18111
Reperfusion Injury
Adverse functional, metabolic, or structural changes in tissues that result from the restoration of blood flow to the tissue (REPERFUSION) following ISCHEMIA.		05.03140
Cardiac Remodeling, Ventricular
[description not available]		05.7671
Asystole
[description not available]		010.52240
Heart Arrest
Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.		05.52240
Ischemia
A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.		09.150
Anoxemia
[description not available]		04.7361
Arrhythmia
[description not available]		09.1204
Heart Disease, Ischemic
[description not available]		012.31449
Hypoxia
Sub-optimal OXYGEN levels in the ambient air of living organisms.		04.7361
Arrhythmias, Cardiac
Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.		09.1204
Myocardial Ischemia
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).		012.31449
Blood Pressure, Low
[description not available]		010.33172
Hypotension
Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients.		010.33172
Apical Ballooning Syndrome
[description not available]		010.7170
Adrenal Cancer
[description not available]		02.4110
Pheochromocytoma, Extra-Adrenal
[description not available]		02.4110
Pheochromocytoma
A usually benign, well-encapsulated, lobular, vascular tumor of chromaffin tissue of the ADRENAL MEDULLA or sympathetic paraganglia. The cardinal symptom, reflecting the increased secretion of EPINEPHRINE and NOREPINEPHRINE, is HYPERTENSION, which may be persistent or intermittent. During severe attacks, there may be HEADACHE; SWEATING, palpitation, apprehension, TREMOR; PALLOR or FLUSHING of the face, NAUSEA and VOMITING, pain in the CHEST and ABDOMEN, and paresthesias of the extremities. The incidence of malignancy is as low as 5% but the pathologic distinction between benign and malignant pheochromocytomas is not clear. (Dorland, 27th ed; DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p1298)		07.4110
Takotsubo Cardiomyopathy
A transient left ventricular apical dysfunction or ballooning accompanied by electrocardiographic (ECG) T wave inversions. This abnormality is associated with high levels of CATECHOLAMINES, either administered or endogenously secreted from a tumor or during extreme stress.		05.7170
Ventricular Septal Perforation
Presence of a hole or holes in the ventricular septum.		02.7620
Acute Disease
Disease having a short and relatively severe course.		018.1710935
Kidney Diseases
Pathological processes of the KIDNEY or its component tissues.		06.5352
Left Ventricular Dysfunction
[description not available]		016.538737
Ventricular Dysfunction, Left
A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.		016.538737
Symptom Cluster
[description not available]		011.52155
Fallot's Tetralogy
[description not available]		04.6322
Syndrome
A characteristic symptom complex.		011.52155
Tetralogy of Fallot
A combination of congenital heart defects consisting of four key features including VENTRICULAR SEPTAL DEFECTS; PULMONARY STENOSIS; RIGHT VENTRICULAR HYPERTROPHY; and a dextro-positioned AORTA. In this condition, blood from both ventricles (oxygen-rich and oxygen-poor) is pumped into the body often causing CYANOSIS.		09.6322
Embolism, Pulmonary
[description not available]		02.9840
Pulmonary Embolism
Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.		02.9840
Inflammatory Response Syndrome, Systemic
[description not available]		02.4110
2019 Novel Coronavirus Disease
[description not available]		02.7220
Systemic Inflammatory Response Syndrome
A systemic inflammatory response to a variety of clinical insults, characterized by two or more of the following conditions: (1) fever		02.4110
Encephalopathy, Traumatic
[description not available]		02.4110
Brain Injuries, Traumatic
A form of acquired brain injury which occurs when a sudden trauma causes damage to the brain.		02.4110
Necrosis
The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.		09.1350
Bleeding
[description not available]		03.3310
Hemorrhage
Bleeding or escape of blood from a vessel.		03.3310
Auricular Fibrillation
[description not available]		07.64172
Atrial Fibrillation
Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation.		07.64172
Critical Illness
A disease or state in which death is possible or imminent.		017.49263
Ventricular Fibrillation
A potentially lethal cardiac arrhythmia that is characterized by uncoordinated extremely rapid firing of electrical impulses (400-600/min) in HEART VENTRICLES. Such asynchronous ventricular quivering or fibrillation prevents any effective cardiac output and results in unconsciousness (SYNCOPE). It is one of the major electrocardiographic patterns seen with CARDIAC ARREST.		03.3360
Intraventricular Septal Defects
[description not available]		04.6722
Pulmonary Arterial Hypertension
A progressive rare pulmonary disease characterized by high blood pressure in the PULMONARY ARTERY.		08.9911
Heart Septal Defects, Ventricular
Developmental abnormalities in any portion of the VENTRICULAR SEPTUM resulting in abnormal communications between the two lower chambers of the heart. Classification of ventricular septal defects is based on location of the communication, such as perimembranous, inlet, outlet (infundibular), central muscular, marginal muscular, or apical muscular defect.		04.6722
Tauopathies
Neurodegenerative disorders involving deposition of abnormal tau protein isoforms (TAU PROTEINS) in neurons and glial cells in the brain. Pathological aggregations of tau proteins are associated with mutation of the tau gene on chromosome 17 in patients with ALZHEIMER DISEASE; DEMENTIA; PARKINSONIAN DISORDERS; progressive supranuclear palsy (SUPRANUCLEAR PALSY, PROGRESSIVE); and corticobasal degeneration.		02.610
Acute Confusional Senile Dementia
[description not available]		02.610
Disease Models, Animal
Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases.		08.68661
Alzheimer Disease
A degenerative disease of the BRAIN characterized by the insidious onset of DEMENTIA. Impairment of MEMORY, judgment, attention span, and problem solving skills are followed by severe APRAXIAS and a global loss of cognitive abilities. The condition primarily occurs after age 60, and is marked pathologically by severe cortical atrophy and the triad of SENILE PLAQUES; NEUROFIBRILLARY TANGLES; and NEUROPIL THREADS. (From Adams et al., Principles of Neurology, 6th ed, pp1049-57)		02.610
Tricuspid Incompetence
[description not available]		02.610
Cardiomyopathy, Hypertrophic Obstructive
[description not available]		03.5210
Cardiomyopathy, Hypertrophic
A form of CARDIAC MUSCLE disease, characterized by left and/or right ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR; HYPERTROPHY, RIGHT VENTRICULAR), frequent asymmetrical involvement of the HEART SEPTUM, and normal or reduced left ventricular volume. Risk factors include HYPERTENSION; AORTIC STENOSIS; and gene MUTATION; (FAMILIAL HYPERTROPHIC CARDIOMYOPATHY).		03.5210
Kidney Failure
A severe irreversible decline in the ability of kidneys to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism.		06.8772
Renal Insufficiency
Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE.		06.8772
Hypothermia, Accidental
[description not available]		02.8130
Hypothermia
Lower than normal body temperature, especially in warm-blooded animals.		02.8130
MODS
[description not available]		07.4391
Multiple Organ Failure
A progressive condition usually characterized by combined failure of several organs such as the lungs, liver, kidney, along with some clotting mechanisms, usually postinjury or postoperative.		07.4391
Aneurysm, Ruptured
The tearing or bursting of the weakened wall of the aneurysmal sac, usually heralded by sudden worsening pain. The great danger of a ruptured aneurysm is the large amount of blood spilling into the surrounding tissues and cavities, causing HEMORRHAGIC SHOCK.		02.5420
Cerebrospinal Fluid Drainage
[description not available]		02.2110
Aneurysm, Anterior Cerebral Artery
[description not available]		02.2110
Intracranial Aneurysm
Abnormal outpouching in the wall of intracranial blood vessels. Most common are the saccular (berry) aneurysms located at branch points in CIRCLE OF WILLIS at the base of the brain. Vessel rupture results in SUBARACHNOID HEMORRHAGE or INTRACRANIAL HEMORRHAGES. Giant aneurysms (		02.2110
Aortic Stenosis
[description not available]		06.2494
Aortic Valve Stenosis
A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.		06.2494
Muscular Weakness
[description not available]		06.0452
Muscle Weakness
A vague complaint of debility, fatigue, or exhaustion attributable to weakness of various muscles. The weakness can be characterized as subacute or chronic, often progressive, and is a manifestation of many muscle and neuromuscular diseases. (From Wyngaarden et al., Cecil Textbook of Medicine, 19th ed, p2251)		06.0452
Acute Kidney Failure
[description not available]		011.64196
Abnormality, Heart
[description not available]		012.522510
Heart Defects, Congenital
Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.		012.522510
Acute Kidney Injury
Abrupt reduction in kidney function. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.		011.64196
Injury, Myocardial Reperfusion
[description not available]		09.96342
Disease Exacerbation
[description not available]		07.12102
Acute Hypercapnic Respiratory Failure
[description not available]		03.5720
Respiratory Insufficiency
Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)		03.5720
Alloxan Diabetes
[description not available]		03.5170
Age-Related Memory Disorders
[description not available]		02.5920
Memory Disorders
Disturbances in registering an impression, in the retention of an acquired impression, or in the recall of an impression. Memory impairments are associated with DEMENTIA; CRANIOCEREBRAL TRAUMA; ENCEPHALITIS; ALCOHOLISM (see also ALCOHOL AMNESTIC DISORDER); SCHIZOPHRENIA; and other conditions.		02.5920
Left Heart Hypoplasia Syndrome
[description not available]		04.8221
Complex Single Ventricle
[description not available]		02.6620
Hypoplastic Left Heart Syndrome
A condition caused by underdevelopment of the whole left half of the heart. It is characterized by hypoplasia of the left cardiac chambers (HEART ATRIUM; HEART VENTRICLE), the AORTA, the AORTIC VALVE, and the MITRAL VALVE. Severe symptoms appear in early infancy when DUCTUS ARTERIOSUS closes.		09.8221
Body Weight
The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms.		04.1631
Diabetic Glomerulosclerosis
[description not available]		02.2510
Hyperglycemia, Postprandial
Abnormally high BLOOD GLUCOSE level after a meal.		02.8630
Diabetic Nephropathies
KIDNEY injuries associated with diabetes mellitus and affecting KIDNEY GLOMERULUS; ARTERIOLES; KIDNEY TUBULES; and the interstitium. Clinical signs include persistent PROTEINURIA, from microalbuminuria progressing to ALBUMINURIA of greater than 300 mg/24 h, leading to reduced GLOMERULAR FILTRATION RATE and END-STAGE RENAL DISEASE.		02.2510
Hyperglycemia
Abnormally high BLOOD GLUCOSE level.		02.8630
Polyuria
Urination of a large volume of urine with an increase in urinary frequency, commonly seen in diabetes (DIABETES MELLITUS; DIABETES INSIPIDUS).		02.2510
Diabetes Mellitus, Adult-Onset
[description not available]		04.1431
Diabetes Mellitus, Type 2
A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY.		04.1431
Tachyarrhythmia
[description not available]		02.7930
Tachycardia
Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia.		02.7930
Tachycardia, Supraventricular
A generic expression for any tachycardia that originates above the BUNDLE OF HIS.		02.2510
Arteriosclerosis, Coronary
[description not available]		09.14148
Coronary Artery Disease
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.		014.14148
Chronic Illness
[description not available]		011.123111
Chronic Disease
Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2).		011.123111
Suffocation
[description not available]		02.8530
Asphyxia
A pathological condition caused by lack of oxygen, manifested in impending or actual cessation of life.		02.8530
Cardiac Toxicity
[description not available]		03.8430
Cardiotoxicity
Damage to the HEART or its function secondary to exposure to toxic substances such as drugs used in CHEMOTHERAPY; IMMUNOTHERAPY; or RADIATION.		03.8430
Amyloidosis
A group of sporadic, familial and/or inherited, degenerative, and infectious disease processes, linked by the common theme of abnormal protein folding and deposition of AMYLOID. As the amyloid deposits enlarge they displace normal tissue structures, causing disruption of function. Various signs and symptoms depend on the location and size of the deposits.		07.2510
Intertrochanteric Fractures
[description not available]		04.821
Hip Fractures
Fractures of the FEMUR HEAD; the FEMUR NECK; (FEMORAL NECK FRACTURES); the trochanters; or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral shaft below the subtrochanteric region (FEMORAL FRACTURES).		09.821
Systolic Heart Failure
[description not available]		04.1731
Heart Failure, Systolic
Heart failure caused by abnormal myocardial contraction during SYSTOLE leading to defective cardiac emptying.		04.1731
Blood Loss, Surgical
Loss of blood during a surgical procedure.		03.2310
Complication, Intraoperative
[description not available]		08.8774
Pregnancy
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.		05.8681
Idiopathic Parkinson Disease
[description not available]		02.2510
Parkinson Disease
A progressive, degenerative neurologic disease characterized by a TREMOR that is maximal at rest, retropulsion (i.e. a tendency to fall backwards), rigidity, stooped posture, slowness of voluntary movements, and a masklike facial expression. Pathologic features include loss of melanin containing neurons in the substantia nigra and other pigmented nuclei of the brainstem. LEWY BODIES are present in the substantia nigra and locus coeruleus but may also be found in a related condition (LEWY BODY DISEASE, DIFFUSE) characterized by dementia in combination with varying degrees of parkinsonism. (Adams et al., Principles of Neurology, 6th ed, p1059, pp1067-75)		02.2510
Circulatory Collapse
[description not available]		04.7440
Shock
A pathological condition manifested by failure to perfuse or oxygenate vital organs.		04.7440
Agenesis of Hemidiaphragm
[description not available]		02.3110
Hernias, Diaphragmatic, Congenital
Protrusion of abdominal structures into the THORAX as a result of embryologic defects in the DIAPHRAGM often present in the neonatal period. It can be isolated, syndromic, non-syndromic or be a part of chromosome abnormality. Associated pulmonary hypoplasia and PULMONARY HYPERTENSION can further complicate stabilization and surgical intervention.		02.3110
Cognitive Decline
[description not available]		02.3110
Cognitive Dysfunction
Diminished or impaired mental and/or intellectual function.		07.3110
Primary Graft Dysfunction
A form of ischemia-reperfusion injury occurring in the early period following transplantation. Significant pathophysiological changes in MITOCHONDRIA are the main cause of the dysfunction. It is most often seen in the transplanted lung, liver, or kidney and can lead to GRAFT REJECTION.		07.3110
Liver Dysfunction
[description not available]		04.1831
Liver Diseases
Pathological processes of the LIVER.		04.1831
Atrophy, Muscle
[description not available]		03.0610
Muscular Atrophy
Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation.		03.0610
Coagulation Disorders, Blood
[description not available]		02.1510
Blood Coagulation Disorders
Hemorrhagic and thrombotic disorders that occur as a consequence of abnormalities in blood coagulation due to a variety of factors such as COAGULATION PROTEIN DISORDERS; BLOOD PLATELET DISORDERS; BLOOD PROTEIN DISORDERS or nutritional conditions.		02.1510
Endotoxemia
A condition characterized by the presence of ENDOTOXINS in the blood. On lysis, the outer cell wall of gram-negative bacteria enters the systemic circulation and initiates a pathophysiologic cascade of pro-inflammatory mediators.		04.68100
Acute Coronary Syndrome
An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.		04.740
Mitral Incompetence
[description not available]		06.0274
Mitral Valve Insufficiency
Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.		06.0274
Bronchial Hyperreactivity
Tendency of the smooth muscle of the tracheobronchial tree to contract more intensely in response to a given stimulus than it does in the response seen in normal individuals. This condition is present in virtually all symptomatic patients with asthma. The most prominent manifestation of this smooth muscle contraction is a decrease in airway caliber that can be readily measured in the pulmonary function laboratory.		02.1510
HIV Coinfection
[description not available]		02.1510
HIV Infections
Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS).		02.1510
Chest Injuries
[description not available]		02.1510
Blunt Injuries
[description not available]		02.1510
Chronic Kidney Diseases
[description not available]		03.5611
Renal Insufficiency, Chronic
Conditions in which the KIDNEYS perform below the normal level for more than three months. Chronic kidney insufficiency is classified by five stages according to the decline in GLOMERULAR FILTRATION RATE and the degree of kidney damage (as measured by the level of PROTEINURIA). The most severe form is the end-stage renal disease (CHRONIC KIDNEY FAILURE). (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002)		03.5611
Hypertrophy
General increase in bulk of a part or organ due to CELL ENLARGEMENT and accumulation of FLUIDS AND SECRETIONS, not due to tumor formation, nor to an increase in the number of cells (HYPERPLASIA).		02.1710
Chronic Lung Injury
[description not available]		02.5420
Wounds, Penetrating
Wounds caused by objects penetrating the skin.		02.1710
Cardiomyopathy, Congestive
[description not available]		07.73174
Cardiomyopathy, Dilated
A form of CARDIAC MUSCLE disease that is characterized by ventricular dilation, VENTRICULAR DYSFUNCTION, and HEART FAILURE. Risk factors include SMOKING; ALCOHOL DRINKING; HYPERTENSION; INFECTION; PREGNANCY; and mutations in the LMNA gene encoding LAMIN TYPE A, a NUCLEAR LAMINA protein.		07.73174
Anesthesia Related Hyperthermia
[description not available]		02.1710
Muscle Contraction
A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments.		07.32132
Becker Muscular Dystrophy
[description not available]		02.2110
Experimental Lung Inflammation
Inflammation of any part, segment or lobe, of the lung parenchyma.		02.2110
Pneumonia
Infection of the lung often accompanied by inflammation.		02.2110
Muscular Dystrophy, Duchenne
An X-linked recessive muscle disease caused by an inability to synthesize DYSTROPHIN, which is involved with maintaining the integrity of the sarcolemma. Muscle fibers undergo a process that features degeneration and regeneration. Clinical manifestations include proximal weakness in the first few years of life, pseudohypertrophy, cardiomyopathy (see MYOCARDIAL DISEASES), and an increased incidence of impaired mentation. Becker muscular dystrophy is a closely related condition featuring a later onset of disease (usually adolescence) and a slowly progressive course. (Adams et al., Principles of Neurology, 6th ed, p1415)		02.2110
Deafness, Transitory
[description not available]		02.2110
Hearing Loss
A general term for the complete or partial loss of the ability to hear from one or both ears.		02.2110
Neonatal Early-Onset Sepsis
[description not available]		03.1210
Asphyxia Neonatorum
Respiratory failure in the newborn. (Dorland, 27th ed)		03.1210
ACD-MPV
[description not available]		03.1210
Neonatal Sepsis
Blood infection that occurs in an infant younger than 90 days old. Early-onset sepsis is seen in the first week of life and most often appears within 24 hours of birth. Late-onset occurs after 1 week and before 3 months of age.		03.1210
Persistent Fetal Circulation Syndrome
A syndrome of persistent PULMONARY HYPERTENSION in the newborn infant (INFANT, NEWBORN) without demonstrable HEART DISEASES. This neonatal condition can be caused by severe pulmonary vasoconstriction (reactive type), hypertrophy of pulmonary arterial muscle (hypertrophic type), or abnormally developed pulmonary arterioles (hypoplastic type). The newborn patient exhibits CYANOSIS and ACIDOSIS due to the persistence of fetal circulatory pattern of right-to-left shunting of blood through a patent ductus arteriosus (DUCTUS ARTERIOSUS, PATENT) and at times a patent foramen ovale (FORAMEN OVALE, PATENT).		03.1210
Acute Respiratory Distress Syndrome
[description not available]		09.3541
Respiratory Distress Syndrome
A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA.		09.3541
ST Elevated Myocardial Infarction
[description not available]		03.9821
ST Elevation Myocardial Infarction
A clinical syndrome defined by MYOCARDIAL ISCHEMIA symptoms; persistent elevation in the ST segments of the ELECTROCARDIOGRAM; and release of BIOMARKERS of myocardial NECROSIS (e.g., elevated TROPONIN levels). ST segment elevation in the ECG is often used in determining the treatment protocol (see also NON-ST ELEVATION MYOCARDIAL INFARCTION).		08.9821
Hypokalemia
Abnormally low potassium concentration in the blood. It may result from potassium loss by renal secretion or by the gastrointestinal route, as by vomiting or diarrhea. It may be manifested clinically by neuromuscular disorders ranging from weakness to paralysis, by electrocardiographic abnormalities (depression of the T wave and elevation of the U wave), by renal disease, and by gastrointestinal disorders. (Dorland, 27th ed)		02.2110
Experimental Mammary Neoplasms
[description not available]		02.2510
Cardiac Septal Defect
[description not available]		03.5911
Carditis
[description not available]		04.76110
Myocarditis
Inflammatory processes of the muscular walls of the heart (MYOCARDIUM) which result in injury to the cardiac muscle cells (MYOCYTES, CARDIAC). Manifestations range from subclinical to sudden death (DEATH, SUDDEN). Myocarditis in association with cardiac dysfunction is classified as inflammatory CARDIOMYOPATHY usually caused by INFECTION, autoimmune diseases, or responses to toxic substances. Myocarditis is also a common cause of DILATED CARDIOMYOPATHY and other cardiomyopathies.		04.76110
Acute Myelogenous Leukemia
[description not available]		03.0110
Neuroblastoma
A common neoplasm of early childhood arising from neural crest cells in the sympathetic nervous system, and characterized by diverse clinical behavior, ranging from spontaneous remission to rapid metastatic progression and death. This tumor is the most common intraabdominal malignancy of childhood, but it may also arise from thorax, neck, or rarely occur in the central nervous system. Histologic features include uniform round cells with hyperchromatic nuclei arranged in nests and separated by fibrovascular septa. Neuroblastomas may be associated with the opsoclonus-myoclonus syndrome. (From DeVita et al., Cancer: Principles and Practice of Oncology, 5th ed, pp2099-2101; Curr Opin Oncol 1998 Jan;10(1):43-51)		03.0110
Leukemia, Myeloid, Acute
Clonal expansion of myeloid blasts in bone marrow, blood, and other tissue. Myeloid leukemias develop from changes in cells that normally produce NEUTROPHILS; BASOPHILS; EOSINOPHILS; and MONOCYTES.		03.0110
Atherogenesis
[description not available]		02.110
Aneurysm, Iliac
[description not available]		02.110
Atherosclerosis
A thickening and loss of elasticity of the walls of ARTERIES that occurs with formation of ATHEROSCLEROTIC PLAQUES within the ARTERIAL INTIMA.		02.110
Thromboembolism
Obstruction of a blood vessel (embolism) by a blood clot (THROMBUS) in the blood stream.		02.0810
Deep Vein Thrombosis
[description not available]		02.0810
Venous Thrombosis
The formation or presence of a blood clot (THROMBUS) within a vein.		02.0810
Enterovirus Infections
Diseases caused by ENTEROVIRUS.		02.0810
Cerebral Infarction, Middle Cerebral Artery
[description not available]		02.0810
Apoplexy
[description not available]		02.520
Cerebral Ischemia
[description not available]		07.520
Brain Ischemia
Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION.		02.520
Infarction, Middle Cerebral Artery
NECROSIS occurring in the MIDDLE CEREBRAL ARTERY distribution system which brings blood to the entire lateral aspects of each CEREBRAL HEMISPHERE. Clinical signs include impaired cognition; APHASIA; AGRAPHIA; weak and numbness in the face and arms, contralaterally or bilaterally depending on the infarction.		02.0810
Stroke
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)		07.520
Left Ventricular Hypertrophy
[description not available]		09.7132
Hypertrophy, Left Ventricular
Enlargement of the LEFT VENTRICLE of the heart. This increase in ventricular mass is attributed to sustained abnormal pressure or volume loads and is a contributor to cardiovascular morbidity and mortality.		04.7132
Heritable Pulmonary Arterial Hypertension
[description not available]		03.8721
Familial Primary Pulmonary Hypertension
Familial or idiopathic hypertension in the PULMONARY CIRCULATION which is not secondary to other disease.		03.8721
Anesthesia
A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures.		05.9491
Ventricular Dysfunction
A condition in which HEART VENTRICLES exhibit impaired function.		07.1790
Left Ventricular Outflow Obstruction
[description not available]		02.4820
Cognition Disorders
Disorders characterized by disturbances in mental processes related to learning, thinking, reasoning, and judgment.		02.110
Acute Brain Injuries
[description not available]		03.6930
Brain Injuries
Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.		03.6930
Hepatic Failure
[description not available]		02.110
Liver Failure
Severe inability of the LIVER to perform its normal metabolic functions, as evidenced by severe JAUNDICE and abnormal serum levels of AMMONIA; BILIRUBIN; ALKALINE PHOSPHATASE; ASPARTATE AMINOTRANSFERASE; LACTATE DEHYDROGENASES; and albumin/globulin ratio. (Blakiston's Gould Medical Dictionary, 4th ed)		02.110
Hibernation, Myocardial
[description not available]		010.31272
Electrolytes
Substances that dissociate into two or more ions, to some extent, in water. Solutions of electrolytes thus conduct an electric current and can be decomposed by it (ELECTROLYSIS). (Grant & Hackh's Chemical Dictionary, 5th ed)		02.110
Lung Injury, Acute
[description not available]		03.0140
Acute Lung Injury
A condition of lung damage that is characterized by bilateral pulmonary infiltrates (PULMONARY EDEMA) rich in NEUTROPHILS, and in the absence of clinical HEART FAILURE. This can represent a spectrum of pulmonary lesions, endothelial and epithelial, due to numerous factors (physical, chemical, or biological).		03.0140
Arterio-Arterial Fistula
Abnormal communication between two ARTERIES that may result from injury or occur as a congenital abnormality.		02.110
Primary Peritonitis
[description not available]		03.1750
Peritonitis
INFLAMMATION of the PERITONEUM lining the ABDOMINAL CAVITY as the result of infectious, autoimmune, or chemical processes. Primary peritonitis is due to infection of the PERITONEAL CAVITY via hematogenous or lymphatic spread and without intra-abdominal source. Secondary peritonitis arises from the ABDOMINAL CAVITY itself through RUPTURE or ABSCESS of intra-abdominal organs.		08.1750
Sensitivity and Specificity
Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)		08.0394
Disease, Pulmonary
[description not available]		02.4620
Lung Diseases
Pathological processes involving any part of the LUNG.		02.4620
Puerperal Disorders
Disorders or diseases associated with PUERPERIUM, the six-to-eight-week period immediately after PARTURITION in humans.		03.0310
Cardiovascular Pregnancy Complications
[description not available]		05.0531
Diabetic Cardiomyopathies
Diabetes complications in which VENTRICULAR REMODELING in the absence of CORONARY ATHEROSCLEROSIS and hypertension results in cardiac dysfunctions, typically LEFT VENTRICULAR DYSFUNCTION. The changes also result in myocardial hypertrophy, myocardial necrosis and fibrosis, and collagen deposition due to impaired glucose tolerance.		02.1310
Acute Liver Injury, Drug-Induced
[description not available]		02.1110
Chemical and Drug Induced Liver Injury
A spectrum of clinical liver diseases ranging from mild biochemical abnormalities to ACUTE LIVER FAILURE, caused by drugs, drug metabolites, herbal and dietary supplements and chemicals from the environment.		02.1110
Abdomen, Acute
A clinical syndrome with acute abdominal pain that is severe, localized, and rapid in onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases.		02.1310
Ileus
A condition caused by the lack of intestinal PERISTALSIS or INTESTINAL MOTILITY without any mechanical obstruction. This interference of the flow of INTESTINAL CONTENTS often leads to INTESTINAL OBSTRUCTION. Ileus may be classified into postoperative, inflammatory, metabolic, neurogenic, and drug-induced.		02.1310
Hypertrophy, Right Ventricular
Enlargement of the RIGHT VENTRICLE of the heart. This increase in ventricular mass is often attributed to PULMONARY HYPERTENSION and is a contributor to cardiovascular morbidity and mortality.		02.1310
Neuromuscular Blockade
The intentional interruption of transmission at the NEUROMUSCULAR JUNCTION by external agents, usually neuromuscular blocking agents. It is distinguished from NERVE BLOCK in which nerve conduction (NEURAL CONDUCTION) is interrupted rather than neuromuscular transmission. Neuromuscular blockade is commonly used to produce MUSCLE RELAXATION as an adjunct to anesthesia during surgery and other medical procedures. It is also often used as an experimental manipulation in basic research. It is not strictly speaking anesthesia but is grouped here with anesthetic techniques. The failure of neuromuscular transmission as a result of pathological processes is not included here.		02.1510
Coronary Occlusion
Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.		07.1310
Alveolitis, Fibrosing
[description not available]		02.1310
Pulmonary Fibrosis
A process in which normal lung tissues are progressively replaced by FIBROBLASTS and COLLAGEN causing an irreversible loss of the ability to transfer oxygen into the bloodstream via PULMONARY ALVEOLI. Patients show progressive DYSPNEA finally resulting in death.		07.1310
Post-Traumatic Subarachnoid Hemorrhage
[description not available]		02.1310
Muscle Relaxation
That phase of a muscle twitch during which a muscle returns to a resting position.		04.260
Chronic Kidney Failure
[description not available]		04.3741
Kidney Failure, Chronic
The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.		04.3741
Absence Seizure
[description not available]		02.1510
Seizures
Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as EPILEPSY or seizure disorder.		07.1510
Dehiscence, Surgical Wound
[description not available]		02.1510
Abnormalities, Multiple
Congenital abnormalities that affect more than one organ or body structure.		02.0410
Cardiomyopathy, Chagas
[description not available]		02.0510
Chagas Cardiomyopathy
A disease of the CARDIAC MUSCLE developed subsequent to the initial protozoan infection by TRYPANOSOMA CRUZI. After infection, less than 10% develop acute illness such as MYOCARDITIS (mostly in children). The disease then enters a latent phase without clinical symptoms until about 20 years later. Myocardial symptoms of advanced CHAGAS DISEASE include conduction defects (HEART BLOCK) and CARDIOMEGALY.		02.0510
Dextro-Looped Transposition of the Great Arteries
[description not available]		03.3620
Transposition of Great Vessels
A congenital cardiovascular malformation in which the AORTA arises entirely from the RIGHT VENTRICLE, and the PULMONARY ARTERY arises from the LEFT VENTRICLE. Consequently, the pulmonary and the systemic circulations are parallel and not sequential, so that the venous return from the peripheral circulation is re-circulated by the right ventricle via aorta to the systemic circulation without being oxygenated in the lungs. This is a potentially lethal form of heart disease in newborns and infants.		03.3620
Airflow Obstruction, Chronic
[description not available]		02.4620
Cancer of Lung
[description not available]		02.0510
Lung Neoplasms
Tumors or cancer of the LUNG.		02.0510
Pulmonary Disease, Chronic Obstructive
A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.		02.4620
Blood Pressure, High
[description not available]		03.1550
Hypertension
Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.		08.1550
Bilateral Headache
[description not available]		04.7221
Headache
The symptom of PAIN in the cranial region. It may be an isolated benign occurrence or manifestation of a wide variety of HEADACHE DISORDERS.		04.7221
Coronary Artery Stenosis
[description not available]		04.7971
Coronary Stenosis
Narrowing or constriction of a coronary artery.		04.7971
Bradyarrhythmia
[description not available]		02.0510
Bradycardia
Cardiac arrhythmias that are characterized by excessively slow HEART RATE, usually below 50 beats per minute in human adults. They can be classified broadly into SINOATRIAL NODE dysfunction and ATRIOVENTRICULAR BLOCK.		02.0510
Cardiac Free Wall Rupture
[description not available]		02.0510
Lactic Acidosis
[description not available]		02.0510
Coma
A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION.		02.0510
Acidosis, Lactic
Acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized. It may occur spontaneously or in association with diseases such as DIABETES MELLITUS; LEUKEMIA; or LIVER FAILURE.		02.0510
Drug Overdose
Accidental or deliberate use of a medication or street drug in excess of normal dosage.		02.9640
Atrioventricular Nodal Re-Entrant Tachycardia
[description not available]		04.1331
Tachycardia, Ventricular
An abnormally rapid ventricular rhythm usually in excess of 150 beats per minute. It is generated within the ventricle below the BUNDLE OF HIS, either as autonomic impulse formation or reentrant impulse conduction. Depending on the etiology, onset of ventricular tachycardia can be paroxysmal (sudden) or nonparoxysmal, its wide QRS complexes can be uniform or polymorphic, and the ventricular beating may be independent of the atrial beating (AV dissociation).		04.1331
Compensatory Hyperinsulinemia
A GLUCOSE-induced HYPERINSULINEMIA, a marker of insulin-resistant state. It is a mechanism to compensate for reduced sensitivity to insulin.		02.0510
Hyperinsulinism
A syndrome with excessively high INSULIN levels in the BLOOD. It may cause HYPOGLYCEMIA. Etiology of hyperinsulinism varies, including hypersecretion of a beta cell tumor (INSULINOMA); autoantibodies against insulin (INSULIN ANTIBODIES); defective insulin receptor (INSULIN RESISTANCE); or overuse of exogenous insulin or HYPOGLYCEMIC AGENTS.		02.0510
Complications of Diabetes Mellitus
[description not available]		02.0510
Cardiac Hypertrophy
Enlargement of the HEART due to chamber HYPERTROPHY, an increase in wall thickness without an increase in the number of cells (MYOCYTES, CARDIAC). It is the result of increase in myocyte size, mitochondrial and myofibrillar mass, as well as changes in extracellular matrix.		02.4620
Cardiomegaly
Enlargement of the HEART, usually indicated by a cardiothoracic ratio above 0.50. Heart enlargement may involve the right, the left, or both HEART VENTRICLES or HEART ATRIA. Cardiomegaly is a nonspecific symptom seen in patients with chronic systolic heart failure (HEART FAILURE) or several forms of CARDIOMYOPATHIES.		02.4620
Coxsackie Virus Infections
[description not available]		02.0510
Metabolic Acidosis
[description not available]		03.2860
E coli Infections
[description not available]		02.7230
Acidosis
A pathologic condition of acid accumulation or depletion of base in the body. The two main types are RESPIRATORY ACIDOSIS and metabolic acidosis, due to metabolic acid build up.		03.2860
Escherichia coli Infections
Infections with bacteria of the species ESCHERICHIA COLI.		02.7230
Muscle Disorders
[description not available]		02.9710
Muscular Diseases
Acquired, familial, and congenital disorders of SKELETAL MUSCLE and SMOOTH MUSCLE.		02.9710
Extrasystole, Ventricular
[description not available]		03.4411
Atrioventricular Conduction Block
[description not available]		02.0610
Atrioventricular Block
Impaired impulse conduction from HEART ATRIA to HEART VENTRICLES. AV block can mean delayed or completely blocked impulse conduction.		02.0610
Airway Remodeling
The structural changes in the number, mass, size and/or composition of the airway tissues.		03.4511
Deficiency, Glucosephosphatase
[description not available]		02.0610
Glycogen Storage Disease Type I
An autosomal recessive disease in which gene expression of glucose-6-phosphatase is absent, resulting in hypoglycemia due to lack of glucose production. Accumulation of glycogen in liver and kidney leads to organomegaly, particularly massive hepatomegaly. Increased concentrations of lactic acid and hyperlipidemia appear in the plasma. Clinical gout often appears in early childhood.		02.0610
Hypercapnia
A clinical manifestation of abnormal increase in the amount of carbon dioxide in arterial blood.		03.4711
Hyperventilation
A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide.		08.4711
Anoxia, Fetal
[description not available]		02.4820
Fetal Hypoxia
Deficient oxygenation of FETAL BLOOD.		02.4820
Constriction, Pathological
[description not available]		02.0610
Constriction, Pathologic
The condition of an anatomical structure's being constricted beyond normal dimensions.		02.0610
Ascites
Accumulation or retention of free fluid within the peritoneal cavity.		02.0710
Anemia
A reduction in the number of circulating ERYTHROCYTES or in the quantity of HEMOGLOBIN.		02.4520
Anoxia-Ischemia, Brain
[description not available]		02.0710
Hypoxia-Ischemia, Brain
A disorder characterized by a reduction of oxygen in the blood combined with reduced blood flow (ISCHEMIA) to the brain from a localized obstruction of a cerebral artery or from systemic hypoperfusion. Prolonged hypoxia-ischemia is associated with ISCHEMIC ATTACK, TRANSIENT; BRAIN INFARCTION; BRAIN EDEMA; COMA; and other conditions.		02.0710
Diabetes Mellitus
A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.		02.9910
Anasarca
[description not available]		02.0810
Edema
Abnormal fluid accumulation in TISSUES or body cavities. Most cases of edema are present under the SKIN in SUBCUTANEOUS TISSUE.		02.0810
47,XX,+21
[description not available]		02.0710
Down Syndrome
A chromosome disorder associated either with an extra chromosome 21 or an effective trisomy for chromosome 21. Clinical manifestations include hypotonia, short stature, brachycephaly, upslanting palpebral fissures, epicanthus, Brushfield spots on the iris, protruding tongue, small ears, short, broad hands, fifth finger clinodactyly, Simian crease, and moderate to severe INTELLECTUAL DISABILITY. Cardiac and gastrointestinal malformations, a marked increase in the incidence of LEUKEMIA, and the early onset of ALZHEIMER DISEASE are also associated with this condition. Pathologic features include the development of NEUROFIBRILLARY TANGLES in neurons and the deposition of AMYLOID BETA-PROTEIN, similar to the pathology of ALZHEIMER DISEASE. (Menkes, Textbook of Child Neurology, 5th ed, p213)		02.0710
Bile Duct Obstruction
[description not available]		02.0810
Cholestasis
Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).		02.0810
Grippe
[description not available]		02.0710
Influenza, Human
An acute viral infection in humans involving the respiratory tract. It is marked by inflammation of the NASAL MUCOSA; the PHARYNX; and conjunctiva, and by headache and severe, often generalized, myalgia.		02.0710
Breathlessness
[description not available]		04.7321
Dyspnea
Difficult or labored breathing.		04.7321
Elevated Cholesterol
[description not available]		02.9310
Hypercholesterolemia
A condition with abnormally high levels of CHOLESTEROL in the blood. It is defined as a cholesterol value exceeding the 95th percentile for the population.		02.9310
Coronary Heart Disease
[description not available]		05.3572
Coronary Disease
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.		05.3572
Cardiac Arrest, Sudden
[description not available]		03.411
Death, Sudden, Cardiac
Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005)		03.411
Apnea
A transient absence of spontaneous respiration.		02.0210
Coronary Vessel Anomalies
Malformations of CORONARY VESSELS, either arteries or veins. Included are anomalous origins of coronary arteries; ARTERIOVENOUS FISTULA; CORONARY ANEURYSM; MYOCARDIAL BRIDGING; and others.		02.0210
Edema, Pulmonary
[description not available]		02.9310
Pulmonary Edema
Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening.		02.9310
Anterior Fascicular Block
[description not available]		02.0210
A-V Dissociation
[description not available]		02.0210
Bouillaud Disease
[description not available]		02.0210
Rheumatic Heart Disease
Cardiac manifestation of systemic rheumatological conditions, such as RHEUMATIC FEVER. Rheumatic heart disease can involve any part the heart, most often the HEART VALVES and the ENDOCARDIUM.		02.0210
Candida Infection
[description not available]		02.0210
Health Care Associated Infection
[description not available]		02.0210
Candidiasis
Infection with a fungus of the genus CANDIDA. It is usually a superficial infection of the moist areas of the body and is generally caused by CANDIDA ALBICANS. (Dorland, 27th ed)		02.0210
Cross Infection
Any infection which a patient contracts in a health-care institution.		02.0210
Cardiac Output, High
A state of elevated cardiac output due to conditions of either increased hemodynamic demand or reduced cardiac oxygen output. These conditions may include ANEMIA; ARTERIOVENOUS FISTULA; THYROTOXICOSIS; PREGNANCY; EXERCISE; FEVER; and HYPOXIA. In time, compensatory changes of the heart can lead to pathological form of high cardiac output and eventual HEART FAILURE.		02.0210
Weight Reduction
[description not available]		02.0210
Weight Loss
Decrease in existing BODY WEIGHT.		07.0210
Pleuropericarditis
Inflammation of both the PERICARDIUM and the PLEURA.		02.0210
Pericarditis
Inflammation of the PERICARDIUM from various origins, such as infection, neoplasm, autoimmune process, injuries, or drug-induced. Pericarditis usually leads to PERICARDIAL EFFUSION, or CONSTRICTIVE PERICARDITIS.		02.0210
Facial Neoplasms
New abnormal growth of tissue in the FACE.		02.0310
Mitral Stenosis
[description not available]		02.0310
Mitral Valve Stenosis
Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.		02.0310
Angor Pectoris
[description not available]		04.7421
Angina Pectoris
The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.		04.7421
Carbon Monoxide Poisoning
Toxic asphyxiation due to the displacement of oxygen from oxyhemoglobin by carbon monoxide.		07.0310
Delayed Postpartum Hemorrhage
[description not available]		02.0310
Endometrial Diseases
[description not available]		02.0310
Postpartum Hemorrhage
Excess blood loss from uterine bleeding associated with OBSTETRIC LABOR or CHILDBIRTH. It is defined as blood loss greater than 500 ml or of the amount that adversely affects the maternal physiology, such as BLOOD PRESSURE and HEMATOCRIT. Postpartum hemorrhage is divided into two categories, immediate (within first 24 hours after birth) or delayed (after 24 hours postpartum).		02.0310
Uterine Diseases
Pathological processes involving any part of the UTERUS.		02.0310
Breast Cancer
[description not available]		02.0310
Breast Neoplasms
Tumors or cancer of the human BREAST.		02.0310
Convulsions, Grand Mal
[description not available]		02.0310
Injuries, Lightning
[description not available]		02.0310
Epilepsy, Tonic-Clonic
A generalized seizure disorder characterized by recurrent major motor seizures. The initial brief tonic phase is marked by trunk flexion followed by diffuse extension of the trunk and extremities. The clonic phase features rhythmic flexor contractions of the trunk and limbs, pupillary dilation, elevations of blood pressure and pulse, urinary incontinence, and tongue biting. This is followed by a profound state of depressed consciousness (post-ictal state) which gradually improves over minutes to hours. The disorder may be cryptogenic, familial, or symptomatic (caused by an identified disease process). (From Adams et al., Principles of Neurology, 6th ed, p329)		02.0310
Infant, Premature, Diseases
Diseases that occur in PREMATURE INFANTS.		02.0310
Infections, Pneumococcal
[description not available]		02.0310
Pneumococcal Infections
Infections with bacteria of the species STREPTOCOCCUS PNEUMONIAE.		02.0310
Eosinophilia, Pulmonary
[description not available]		02.0310
Pulmonary Eosinophilia
A condition characterized by infiltration of the lung with EOSINOPHILS due to inflammation or other disease processes. Major eosinophilic lung diseases are the eosinophilic pneumonias caused by infections, allergens, or toxic agents.		02.0310
Emergencies
Situations or conditions requiring immediate intervention to avoid serious adverse results.		03.3620
Poisoning
Used with drugs, chemicals, and industrial materials for human or animal poisoning, acute or chronic, whether the poisoning is accidental, occupational, suicidal, by medication error, or by environmental exposure.		07.0410
Atrophy
Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes.		02.9610
Experimental Spinal Cord Ischemia
[description not available]		02.0410
Abdominal Aortic Aneurysm
[description not available]		08.4311
Aortic Aneurysm, Abdominal
An abnormal balloon- or sac-like dilatation in the wall of the ABDOMINAL AORTA which gives rise to the visceral, the parietal, and the terminal (iliac) branches below the aortic hiatus at the diaphragm.		03.4311
Ventilator-Associated Pneumonia
[description not available]		02.9610
Pneumonia, Ventilator-Associated
Serious INFLAMMATION of the LUNG in patients who required the use of PULMONARY VENTILATOR. It is usually caused by bacterial CROSS INFECTION in hospitals.		02.9610
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