Clinical observation of levosimendan in the treatment of refractory congestive heart failure / 药学实践杂志

ABSTRACT

Objective To evaluate the efficacy of loading or non loading administration of levosimendan in the treatment of pa -tients with refractory congestive heart failure (RCHF).Methods A randomized, open, control clinical trial was conducted in 40 pa-tients with RCHF.Besides regular treatment , patients in test group ( n=20) were given levosimendan injection with initial loading dose of 6-12 μg/kg for 10 min,followed by a continuous infusion of 0.1 μg/(kg· min).While in control group (n=20), patients were given Levosimendan injection with a continuous infusion of 8.7μg/min for 24 h.Dyspnea, eject fraction(EF),BNP level, blood pressure, heart rate, rhythm of the heart, the function of liver and kidney before and after drug administration were examined .All ad-verse events during the process were recorded .Results The base line showed there was no significant difference between the 2 groups. Dyspnea degree , general clinical condition , BNP, EF values were all improved , compared with those in patients before treatment .Af-ter 30 min of administration, in test group improved dyspnea , decreased systolic and diastolic blood pressure were more greatly than those in control group (P=0.04 and 0.01, respectively).However there were no significant differences of dyspnea degree , decreased BNP, between the 2 groups after administration of 6 h, 24 h, and 72 h.In addition, there was no significant difference in enhanced EF value at 24 h, 72 h between the 2 groups.Conclusion Levosimendan was effective in treating RCHF and could improve hemodynam-ic, degree of dyspnea and decrease BNP , increase EF value.Compared with loading group, non loading administration of levosimendan in the treatment of RCHF was equivalent , safe, and more convenient .