{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T03:01:21Z","timestamp":1776481281137,"version":"3.51.2"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2010,3,2]],"date-time":"2010-03-02T00:00:00Z","timestamp":1267488000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This the case of a 63 year-old man with end-stage renal disease (on chronic hemodialysis), unstable angina and significantly impaired myocardial contractility with low left ventricular ejection fraction, who underwent off-pump one vessel coronary bypass surgery. Combined continuous levosimendan and norepinephrine infusion (at 0.07 \u03bcg\/kg\/min and 0.05 \u03bcg\/kg\/min respectively) started immediately after anesthesia induction and continued for 24 hours. The levosimendan\/norepinephrine combination helped maintain an appropriate hemodynamic profile, thereby contributing to uneventful completion of surgery and postoperative hemodynamic stability. Although levosimendan is considered contraindicated in ESRD patients, this case report suggests that combined perioperative levosimendan\/norepinephrine administration can be useful in carefully selected hemodialysis patients with impaired myocardial contractility and ongoing myocardial ischemia, who undergo off-pump myocardial revascularization surgery.<\/jats:p>","DOI":"10.1186\/1749-8090-5-9","type":"journal-article","created":{"date-parts":[[2010,3,23]],"date-time":"2010-03-23T07:17:09Z","timestamp":1269328629000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Intravenous levosimendan-norepinephrine combination during off-pump coronary artery bypass grafting in a hemodialysis patient with severe myocardial dysfunction"],"prefix":"10.1186","volume":"5","author":[{"given":"Georgios","family":"Papadopoulos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos G","family":"Baikoussis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petros","family":"Tzimas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stavros N","family":"Siminelakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menelaos","family":"Karanikolas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2010,3,2]]},"reference":[{"key":"242_CR1","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/S0022-3565(25)20945-4","volume":"279","author":"K Todaka","year":"1996","unstructured":"Todaka K, Wang J, Yi GH, Stennett R, Knecht M, Packer M, Burkhoff D: Effects of levosimendan on myocardial contractility and oxygen consumption. J Pharmacol Exp Ther. 1996, 279: 120-127.","journal-title":"J Pharmacol Exp Ther"},{"key":"242_CR2","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1006\/jmcc.1999.1093","volume":"32","author":"J Levijoki","year":"2000","unstructured":"Levijoki J, Pollesello P, Kaivola J, Tilgmann C, Sorsa T, Annila A, Kilpelainen I, Haikala H: Further evidence for the cardiac troponin C mediated calcium sensitization by levosimendan: structure-response and binding analysis with analogs of levosimendan. J Mol Cell Cardiol. 2000, 32: 479-491. 10.1006\/jmcc.1999.1093.","journal-title":"J Mol Cell Cardiol"},{"key":"242_CR3","unstructured":"Simdax - Levosimendan 2.5 mg\/mL injection concentrate - Data Sheet. 2009, New Zealand, New Zealand Medicines and Medical Devices Safety Authority, a Business Unit of the Ministry of Health, 1-10-2010., [http:\/\/www.medsafe.govt.nz\/profs\/Datasheet\/s\/Simdaxinj.htm]"},{"key":"242_CR4","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1001\/jama.297.17.1883","volume":"297","author":"A Mebazaa","year":"2007","unstructured":"Mebazaa A, Nieminen MS, Packer M, Cohen-Solal A, Kleber FX, Pocock SJ, Thakkar R, Padley RJ, Poder P, Kivikko M: Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. JAMA. 2007, 297: 1883-1891. 10.1001\/jama.297.17.1883.","journal-title":"JAMA"},{"key":"242_CR5","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/S0022-3565(24)37957-1","volume":"288","author":"P Bowman","year":"1999","unstructured":"Bowman P, Haikala H, Paul RJ: Levosimendan, a calcium sensitizer in cardiac muscle, induces relaxation in coronary smooth muscle through calcium desensitization. J Pharmacol Exp Ther. 1999, 288: 316-325.","journal-title":"J Pharmacol Exp Ther"},{"key":"242_CR6","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/S0735-1097(97)84373-2","volume":"31","author":"P Keheninen","year":"1998","unstructured":"Keheninen P, Haikala H: Increases in diastolic coronary flow by Levosimendan and pinacidil are differently mediated through opening of the ATP-sensitive potassium channels. J Amer Coll Cardiol. 1998, 31: 154-","journal-title":"J Amer Coll Cardiol"},{"key":"242_CR7","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1211\/0022357001773715","volume":"52","author":"J Pataricza","year":"2000","unstructured":"Pataricza J, Hohn J, Petri A, Balogh A, Papp JG: Comparison of the vasorelaxing effect of cromakalim and the new inodilator, levosimendan, in human isolated portal vein. J Pharm Pharmacol. 2000, 52: 213-217. 10.1211\/0022357001773715.","journal-title":"J Pharm Pharmacol"},{"key":"242_CR8","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/S0022-3565(24)36997-6","volume":"283","author":"H Yokoshiki","year":"1997","unstructured":"Yokoshiki H, Katsube Y, Sunagawa M, Sperelakis N: The novel calcium sensitizer levosimendan activates the ATP-sensitive K+ channel in rat ventricular cells. J Pharmacol Exp Ther. 1997, 283: 375-383.","journal-title":"J Pharmacol Exp Ther"},{"key":"242_CR9","doi-asserted-by":"publisher","first-page":"435","DOI":"10.2174\/1381612053382043","volume":"11","author":"M Kivikko","year":"2005","unstructured":"Kivikko M, Lehtonen L: Levosimendan: a new inodilatory drug for the treatment of decompensated heart failure. Curr Pharm Des. 2005, 11: 435-455. 10.2174\/1381612053382043.","journal-title":"Curr Pharm Des"},{"key":"242_CR10","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1177\/0091270007313390","volume":"48","author":"J Puttonen","year":"2008","unstructured":"Puttonen J, Kantele S, Ruck A, Ramela M, Hakkinen S, Kivikko M, Pentikainen PJ: Pharmacokinetics of intravenous levosimendan and its metabolites in subjects with hepatic impairment. J Clin Pharmacol. 2008, 48: 445-454. 10.1177\/0091270007313390.","journal-title":"J Clin Pharmacol"},{"key":"242_CR11","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1111\/j.1365-2125.2003.02043.x","volume":"57","author":"S Antila","year":"2004","unstructured":"Antila S, Kivikko M, Lehtonen L, Eha J, Heikkila A, Pohjanjousi P, Pentikainen PJ: Pharmacokinetics of levosimendan and its circulating metabolites in patients with heart failure after an extended continuous infusion of levosimendan. Br J Clin Pharmacol. 2004, 57: 412-415. 10.1111\/j.1365-2125.2003.02043.x.","journal-title":"Br J Clin Pharmacol"},{"key":"242_CR12","doi-asserted-by":"publisher","first-page":"830","DOI":"10.1097\/01.fjc.0000189076.71730.f1","volume":"46","author":"AS McLean","year":"2005","unstructured":"McLean AS, Huang SJ, Nalos M, Ting I: Duration of the beneficial effects of levosimendan in decompensated heart failure as measured by echocardiographic indices and B-type natriuretic peptide. J Cardiovasc Pharmacol. 2005, 46: 830-835. 10.1097\/01.fjc.0000189076.71730.f1.","journal-title":"J Cardiovasc Pharmacol"},{"key":"242_CR13","first-page":"109","volume":"6","author":"SC Raftopoulos","year":"2004","unstructured":"Raftopoulos SC: Levosimendan following coronary artery bypass grafting in a patient with end-stage renal failure: a case report. Crit Care Resusc. 2004, 6: 109-112.","journal-title":"Crit Care Resusc"},{"key":"242_CR14","volume-title":"1st Congress of the European Association for Clinical Pharmacology and Therapeutics (EACPT)","author":"EP Sandell","year":"1995","unstructured":"Sandell EP, Antila S, Koistinen IL: The effects of renal failure on the pharmacokinetics of levosimendan [abstract]. 1st Congress of the European Association for Clinical Pharmacology and Therapeutics (EACPT). 1995"},{"key":"242_CR15","first-page":"446","volume":"36","author":"S Antila","year":"1998","unstructured":"Antila S, Honkanen T, Lehtonen L, Neuvonen PJ: The CYP3A4 inhibitor intraconazole does not affect the pharmacokinetics of a new calcium-sensitizing drug levosimendan. Int J Clin Pharmacol Ther. 1998, 36: 446-449.","journal-title":"Int J Clin Pharmacol Ther"},{"key":"242_CR16","doi-asserted-by":"publisher","first-page":"1859","DOI":"10.1016\/0022-2828(95)90009-8","volume":"27","author":"H Haikala","year":"1995","unstructured":"Haikala H, Kaivola J, Nissinen E, Wall P, Levijoki J, Linden IB: Cardiac troponin C as a target protein for a novel calcium sensitizing drug, levosimendan. J Mol Cell Cardiol. 1995, 27: 1859-1866. 10.1016\/0022-2828(95)90009-8.","journal-title":"J Mol Cell Cardiol"},{"issue":"Suppl 1","key":"242_CR17","doi-asserted-by":"publisher","first-page":"S70","DOI":"10.1097\/00005344-199506261-00010","volume":"26","author":"L Lehtonen","year":"1995","unstructured":"Lehtonen L, Mills-Owens P, Akkila J: Safety of levosimendan and other calcium sensitizers. J Cardiovasc Pharmacol. 1995, 26 (Suppl 1): S70-S76.","journal-title":"J Cardiovasc Pharmacol"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-5-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1749-8090-5-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-5-9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1749-8090-5-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T17:09:35Z","timestamp":1739984975000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/1749-8090-5-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3,2]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2010,12]]}},"alternative-id":["242"],"URL":"https:\/\/doi.org\/10.1186\/1749-8090-5-9","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3,2]]},"assertion":[{"value":"17 January 2010","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2010","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2010","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"9"}}