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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Br+J+Pharmacol
2014 ; 171
(23
): 5169-81
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Inhibition of phosphodiesterase-3 by levosimendan is sufficient to account for
its inotropic effect in failing human heart
#MMPMID24547784
Orstavik O
; Ata SH
; Riise J
; Dahl CP
; Andersen GØ
; Levy FO
; Skomedal T
; Osnes JB
; Qvigstad E
Br J Pharmacol
2014[Dec]; 171
(23
): 5169-81
PMID24547784
show ga
BACKGROUND AND PURPOSE: Levosimendan is known as a calcium sensitizer, although
it is also known to inhibit PDE3. We aimed to isolate each component and estimate
their contribution to the increased cardiac contractility induced by
levosimendan. EXPERIMENTAL APPROACH: Contractile force was measured in
electrically stimulated ventricular strips from explanted failing human hearts
and left ventricular strips from normal male Wistar rats. PDE activity was
measured in a two-step PDE activity assay on failing human ventricle. KEY
RESULTS: Levosimendan exerted a positive inotropic effect (PIE) reaching maximum
at 10(-5) ?M in ventricular strips from failing human hearts. In the presence of
the selective PDE3 inhibitor cilostamide, the PIE of levosimendan was abolished.
During treatment with a PDE4 inhibitor and a supra-threshold concentration of
isoprenaline, levosimendan generated an amplified inotropic response. This effect
was reversed by ?-adrenoceptor blockade and undetectable in strips pretreated
with cilostamide. Levosimendan (10(-6) ?M) increased the potency of
?-adrenoceptor agonists by 0.5 log units in failing human myocardium, but not in
the presence of cilostamide. Every inotropic response to levosimendan was
associated with a lusitropic response. Levosimendan did not affect the
concentration-response curve to calcium in rat ventricular strips, in contrast to
the effects of a known calcium sensitizer, EMD57033
[5-(1-(3,4-dimethoxybenzoyl)-1,2,3,4-tetrahydroquinolin-6-yl)-6-methyl-3,6-dihydro-2H-1,3,4-thiadiazin-2-one].
PDE activity assays confirmed that levosimendan inhibited PDE3 as effectively as
cilostamide. CONCLUSIONS AND IMPLICATIONS: Our results indicate that the
PDE3-inhibitory property of levosimendan was enough to account for its inotropic
effect, leaving a minor, if any, effect to a calcium-sensitizing component.