Pediatric Cardiology and Cardiac Surgery
Vol.25 No.5 2009 (665-673)

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Satoshi Masutani and Hideaki Senzaki

Department of Pediatric Cardiology, International Medical Center, Saitama Medical University, Saitama, Japan


Calcium sensitizer exerts positive inotropy and arterial and venous dilation without an increased intracellular calcium level, potentially providing a more effective therapeutic option for heart failure without adverse effects related to intracellular calcium overload. Among those calcium sensitizers, oral pimobendan and intravenous levosimendan have been clinically used. Oral pimobendan has been proved to enhance quality of life without deteriorating of mortality in heart failure trials in Japan. Intravenous levosimendan has been extensively evaluated by several large clinical trials in adults, revealing patients with recurrent heart failure or with a beta-antagonist are the effective clinical targets of this drug. In this article, we review oral pimobendan, oral levosimendan, and intravenous levosimendan from the pediatric clinical perspective as well as in clinical trials on adults.