Short ReviewImpact of levosimendan on platelet function

•Lewosimendan has few key mechanism of action: calcium sentitisation, hyperpolarization and protection of mitochondria.•There are several different trials related to the potential anti-aggregatory effect of levosimendan.•Findings from experimental, observational or randomized clinical studies presented inconsistent results regarding to the topic.

Levosimendan has been developed for treatment of severe heart failure. The favorable hemodynamic effect of levosimendan is related to its unique dual mechanism of action - increase of the contractile force of the myocardium caused by enhanced sensitivity of myofilaments to calcium combined with vasodilatation caused by the opening of adenosine triphosphate - dependent potassium channels. Due to the structural similarities to phosphodiesterase inhibitors it may partly exert its action via inhibition of phosphodiesterase inhibitors III. Inhibition of the phosphodiesterase inhibitors III leads to an increase of intracellular concentration of cyclic adenosine monophosphate causing an anti-aggregatory effect.There are some contradictory or indirect and inconclusive reports related to the impact of levosimendan on platelet function. The aim of this systematic review was to critically discuss the impact of levosimendan on platelet function according to currently available knowledge based on the findings of experimental as well as observational and randomized clinical studies.

Graphical abstractDownload high-res image (132KB)Download full-size image