[Levosimendan, a revolution in the world of inotropic agents?]. / Le levosimendan, une revolution dans le monde des inotropes?

Levosimendan is the first available drug of a new class of agents called calcium sensitizers. It increases cardiac contractility without increasing myocardial oxygen consumption. This new molecule has no proarrhythmic effects and has anti-ischemic properties. Levosimendan is infused over a 24-hour period and its hemodynamic effects, similar or superior to those of catecholamines, persist during one week. In a selected group of advanced heart failure patients levosimendan was associated with a mortality reduction at 14 days and at 6 months in comparison with dobutamine. In spite of its cost, this new inotropic agent appears very promising and it is expected that it will be widely used.