الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Summary Various measures have been used for maintaining adequate cardiac output including positive inotropic agents (epinephrine, nor-epinephrine, dobutamine, milrinone, levosimendan), intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO) and ventricular assisted devices. Calcium sensitizer Levosimendan is a novel inotrope which has been investigated for improving postoperative outcome and mortality after cardiac surgery. Levosimendan has a triple mechanism of action resulting in an inodilator effect which increases cardiac contractility without increasing oxygen consumption. Cardiomyocytes have contractile apparatus composed of Troponin T and I. In practice, Troponin T is only released into the serum after ischemic injury. Normally, after uncomplicated cardiac surgery, there is an obvious increase in levels of cardiac troponin T, which is related to ischemic time. Therefore, measurement of cardiac troponin T will be the indicator for ischemic injury after cardiac surgery in our research. The aim of the work is to evaluate the impact of Levosimendan on high sensitivity cardiac troponin T after valvular heart surgery. All patients above the age of 18, undergoing elective cardias valvular surgery were randomly classified into two equal groups. group A: patients received Levosimendan started during weaning from cardiopulmonary bypass by 6 to 12 μg/kg as a loading dose over 10 minutes followed by 0.05 to 0.2 μg/kg/min as a continuous infusion for 24 hours. group B: patients didn’t receiv