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  • Title: Calcium sensitizers in chronic heart failure: inotropic interventions-reservation to preservation.
    Author: Teramura S, Yamakado T.
    Journal: Cardiologia; 1998 Apr; 43(4):375-85. PubMed ID: 9659795.
    Abstract:
    Newly developed Ca2+ sensitizers possess different mechanisms of action on contractile machinery. Increasing maximal Ca(2+)-activated force in addition to enhancing Ca2+ sensitivity (MCI-154, EMD 53998, and EMD 57033) could exert pronounced positive inotropy and may provide a mechanoenergetic advantage over the classic Ca2+ mobilization in the chronically failing heart. EMD 53998 and EMD 57033 prolong crossbridge attachment time, resulting in negative lusitropy. In contrast, pimobendan, levosimendan, and MCI-154 accelerate left ventricular relaxation in heart failure, because Ca2+ sensitizing action of these agents may be prominent during the early phases of contraction. Therefore, Ca2+ sensitizers can avoid the legacy of problems associated with conventional inotropic interventions and may break through "reservation" to "preservation" in the treatment of chronic heart failure.
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