Levosimendan for sepsis-induced myocardial dysfunction: friend or foe?

Xinxin Du; Fang Xiong; Yafei Hou; Xiangyou Yu; Pengfei Pan

doi:10.3389/fcvm.2024.1520596

Levosimendan for sepsis-induced myocardial dysfunction: friend or foe?

Front Cardiovasc Med. 2025 Jan 8:11:1520596. doi: 10.3389/fcvm.2024.1520596. eCollection 2024.

Authors

Xinxin Du^#^{1

2}, Fang Xiong^#³, Yafei Hou⁴, Xiangyou Yu², Pengfei Pan³

Affiliations

¹ Cardiac Intensive Care Center, Zhongshan Hospital, Fudan University, Shanghai, China.
² Department of Critical Care Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
³ Department of Critical Care Medicine, Chongqing University Three Gorges Hospital, Wanzhou, Chongqing, China.
⁴ Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

^# Contributed equally.

Abstract

Sepsis-induced myocardial dysfunction (SIMD) involves reversible myocardial dysfunction. The use of inotropes can restore adequate cardiac output and tissue perfusion, but conventional inotropes, such as dobutamine and adrenaline, have limited efficacy in such situations. Levosimendan is a novel inotrope that acts in a catecholamine-independent manner. However, study results regarding the treatment of SIMD with levosimendan are inconsistent, and the use of levosimendan is highly controversial. In this review, we summarized the therapeutic mechanisms of levosimendan in SIMD and considered recent research on how to improve the efficacy of levosimendan in SIMD. We also analyzed the potential and limitations of levosimendan for the treatment of SIMD to provide ideas for future clinical trials and the clinical application of levosimendan in SIMD.

Keywords: inotropes; levosimendan; organ protection; sepsis; sepsis-induced myocardial cardiac dysfunction.

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from the Chongqing Medical Scientific Research Project (a joint project of the Chongqing Health Commission and Science and Technology Bureau) (2020FYYX133), the joint medical scientific research project of the Health Commission and Science and Technology Bureau in Wanzhou Chongqing (wzstc- kw2021001) and the National Natural Science Foundation of China (NSFC 82160360).