Table 1.
The main characteristics of included studies.
| Study: first author | Year | Mean age of participants Levosimendan/control (years) |
Number of participants | Setting | Preoperative mean EF (%) | Control | Levosimendan Infusion Dose (μg/kg/min) |
|
|---|---|---|---|---|---|---|---|---|
| Levosimendan/control | Levosimendan | Control | ||||||
| Al-Shawaf et al. | 2006 | 60.5/58 | 14/16 | Elective CABG surgery, EF ≤ 35% | 29 ± 6 | 31 ± 6 | Milrinone | Bolus: 12 μg/kg |
| Inf: 0.1–0.2 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| De hert et al. | 2007 | 67/69 | 15/15 | Elective cardiac surgery with CPB, EF ≤ 30% | 24 ± 6 | 27 ± 3 | Milrinone | Bolus: none |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: NR | ||||||||
|
| ||||||||
| Levin et al. | 2008 | 62.4/61.7 | 69/68 | Coronary surgery with ECC and manifest LCOS | 36.62 ± 4.36 | 38.22 ± 5.24 | Dobutamine | Bolus: 10 μg/kg |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Eriksson et al. | 2009 | 64/64 | 30/30 | CABG with CPB and EF < 50% or acute CHF | 36 ± 8 | 36 ± 8 | Placebo | Bolus: 12 μg/kg |
| Inf: 0.2 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Severi et al. | 2011 | 66/60 | 11/11 | CABG with or without concomitant mitral surgery, EF < 50% | 26 ± 6.2 | 30 ± 6.4 | IABP | Bolus: none |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Lomivorotov et al. | 2012 | 57.3/56.8 | 30/30 | CABG with CPB, EF < 35% | 31 (28–33) | 30 (29–33) | IABP | Bolus: 12 μg/kg |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Levin et al. | 2012 | 63.7/62.9 | 127/125 | Cardiac surgery with CPB, EF < 25% | 17.56 ± 3.24 | 18.62 ± 2.12 | Placebo | Bolus: 10 μg/kg |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Sharma et al. | 2014 | 53.95/54.55 | 20/20 | CABG and mitral valve repair, EF < 25% | 23.55 ± 4.87 | 22.55 ± 0.92 | Placebo | Bolus: none |
| Inf: 200 μg/kg | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Baysal et al. | 2014 | 56.73/58.41 | 64/64 | Mitral valve surgery, EF ≤ 45% | 35.0 (20–50) | 37.5 (25–50) | Standard inotropic agents | Bolus: 6 μg/kg |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Erb et al. | 2014 | 69.5/63.4 | 17/16 | Elective CABG with or without valve surgery, EF ≤ 35% | 22.0 ± 4.5 | 22.4 ± 5.5 | Placebo | Bolus: none |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: NR | ||||||||
|
| ||||||||
| Knezevic et al. | 2014 | 53/49 | 47/47 | Heart transplantation and advanced heart failure | 20 ± 6 | 21 ± 7 | Standard inotropic or vasopressor | Bolus: none |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: NR | ||||||||
|
| ||||||||
| Shah et al. | 2014 | 59.91/61.32 | 25/25 | OPCABG, EF < 30% | 22.45 ± 4.06 | 22.56 ± 3.41 | Placebo | Bolus: none |
| Inf: 0.13 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Anastasiadis et al. | 2016 | 61.1/62.2 | 16/16 | CABG, EF ≤ 40% | 35.7 ± 4.9 | 37.5 ± 3.4 | Placebo | Bolus: none |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Mehta et al. | 2017 | 65/65 | 428/421 | Cardiac surgery with CPB, EF ≤ 35% | 26 (24–32) | 27 (22–31) | Placebo | Bolus: 0.2 μg/kg/min |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
|
| ||||||||
| Cholley et al. | 2017 | 69/67 | 167/168 | CABG with CPB or combined with valve surgery, EF ≤ 40 | ≤40 | ≤40 | Placebo | Bolus: none |
| Inf: 0.1 μg/kg/min | ||||||||
| Duration: 24 h | ||||||||
CABG: coronary aortic bypass grafting; OPCABG: off-pump coronary aortic bypass grafting; CBP: cardiopulmonary bypass; EF: ejection fraction; ECC: extracorporeal circulation; LCOS: low cardiac output syndrome; CHF: congestive heart failure; IABP: intra-aortic balloon pump.