Levosimendan is a cardiovascular drug that functions as an inotrope and a vasodilator with calcium-sensitizing effects. It is reliant on calcium levels in the body and sensitizes tropin C to calcium. It likewise opens ATP-sensitive potassium channels on the smooth muscles of the blood vessels, which then causes heart and blood vessel vasodilation. Opening adenosine triphosphate (ATP)-sensitive potassium channels in vascular smooth muscle causes smooth muscle relaxation, which is a vasodilatory effect. An increased force of contraction, a decreased preload and decreased afterload are results of the combined inotropic and vasodilatory actions. The drug exerts a cardioprotective effect by opening mitochondrial (ATP)-sensitive potassium channels in cardiomyocytes. It is suggested as inotropic support in acutely decompensated severe congestive heart failure when conventional therapy is no longer effective, and in cases when inotropic support should be done appropriately. The use of levosimendan is contraindicated in patients with moderate to severe kidney impairment, severe liver impairment, severe ventricular filling or outflow obstruction, very low blood pressure, fast heart rate, and/or history of abnormal heart rhythm.
