The novel calcium sensitizer and ATP-dependent potassium channel opener levosimendan has been introduced for routine use in several European countries. Recent reports on clinical experience confirm the positive hemodynamic results and beneficial clinical effects described in the initial dose-finding and randomized comparative therapeutic trials in patients with severe low-output heart failure. ...

etabolic adaptation likely represents one of the earliest esponses to myocardial ischemia. The myocardium preferntially oxidizes free fatty acids for energy production. owever, the dependency of fatty acid metabolism on xygen makes this process particularly vulnerable to ischeia. Under hypoxemic or ischemic conditions, the energy equirements of the myocardium are met by glucose rather han free ...