A 60-year-old man on ICU is receiving IV levosimendan for acute decompensated heart failure with cardiogenic shock. What is the unique mechanism of action of levosimendan compared to traditional inotropes? A Levosimendan is a beta-1 agonist like dobutamine B Levosimendan is a calcium sensitiser - it binds to cardiac troponin C and stabilises the calcium-troponin C complex during systole, enhancing myocardial contractility WITHOUT increasing intracellular calcium; it also opens ATP-sensitive potassium channels in vascular smooth muscle, causing vasodilation and cardioprotection C Levosimendan is a phosphodiesterase inhibitor only D Levosimendan directly increases intracellular calcium like digoxin E Levosimendan has no vasodilatory properties
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