Clinical effect of levosimendan in the treatment of intractable heart failure / 中国医师进修杂志

ABSTRACT

Objective To observe the clinical effect and safety oflevosimendan in the treatment of intractable heart failure.Methods One hundred cases of patients with intractable heart failure and cardiac function in NYHA Ⅲ-Ⅳwere enrolled,and the patients were randomly divided into levosimendan group and control group by random digits table method,50 cases in each group.The two groups were given conventional anti heart failure treatment,levosimendan group was treated with levosimendan treatment,control group continued to be given conventional anti heart failure treatment.The left ventricular ejection fraction (LVEF),plasma brain natriuretic peptide (BNP),stroke volume (SV),cardiac output (CO),cardiac index (CI) changes after 12 d of two groups were observed.Results The total effective rate of the levosimendan group was significantly higher than that of the control group [88％ (44/50) vs.42％ (21/50)],the difference was statistically significant (P ＜ 0.05).The two groups before treatment,plasma BNP,LVEF,SV,CO,CI were not significant (P ＞ 0.05).The two groups after treatment of plasma BNP,LVEF,SV,CO,CI were significantly improved than before treatment [levosimendan group:(1 621.3 ± 1 302.1) ng/L vs.(6 530.3 ± 1 620.2) ng/L,(54.7 ± 8.9)％ vs.(38.5 ± 8.7)％,(89.7 ± 8.5) ml vs.(67.1 ± 13.6) ml,(5.30 ±1.60) L/min vs.(3.65 ±2.10) L/min,4.65 ±0.92 vs.2.82 ±0.95; control group:(4 251.2 ± 1 581.3) ng/L vs.(6 495.5 ± 1 640.4) ng/L,(52.6 ± 8.0)％ vs.(39.1 ± 9.2)％,(76.5 ± 8.9)ml vs.(66.4 ± 13.9) ml,(4.36 ± 2.37) L/min vs.(3.71 ± 2.35) L/rmin,3.11 ± 0.73 vs.2.87 ± 0.96],and the levosimendan group improved more obviously,the differences were statistically significant (P ＜ 0.05).The incidence of adverse reactions between two groups had no significant difference (P ＞ 0.05).Conclusion Levosimendan can significandy improve cardiac function in patients with intractable heart failure,increase LVEF,SV,CO and CI,and decrease plasma BNP,and it is safe and reliable.