The effect of Levosimendan on cardiac function of patients with refractory heart failure / 中国中西医结合急救杂志

ABSTRACT

Objective To observe the clinical effect of Levosimendan for treatment of patients with refractory heart failure in order to provide a reference for doctors treating this disease. Methods One hundred and eighty patients with refractory heart failure were admitted to Tongde Hospital of Zhejiang Province from February 2014 to December 2017, and they were divided into two groups by random number table method: a western medicine routine treatment group (western control group) and a Levosimendan group, each group 90 cases. The patients in western control group were given conventional anti-cardiac failure drugs ; and those in Levosimendan group were treated with the therapies as above group, and additionally Levosimendan continuous intravenous infusion for 24 hours was given. The clinical efficacy of the two groups was evaluated after 3 days of treatment. After treatment, the differences of ejection fraction (EF), stroke volume (SV), end-systolic volume (ESV), end-diastolic volume (EDV) and the levels of N-terminal brain natriuretic peptide precursor (NT-proBNP) and cardiac troponin I (cTnI) were compared between the two groups. Results After treatment, the EF and SV levels were significantly increased, while the ESV, EDV, NT-proBNP and cTnI levels were decreased obviously compared with those before treatment in the two groups (all P <0.05); the changes of the levels of EF, SV and NT-proBNP and cTnI of Levosimendan group were more significant than those of the western control group [EF 0.49±0.06 vs. 0.44±0.06, SV (mL) 86.54±17.63 vs. 81.48±18.46, NT-proBNP (μg/L) 5.50±1.28 vs. 6.64±1.54, cTnI (μg/L) 0.08±0.01 vs. 0.14±0.13, all P < 0.05], while there were no significant differences of the levels of ESV and EDV between the two groups [ESV (mL) 111.56±32.53 vs. 128.76±32.13, EDV (mL) 187.95±39.28 vs. 185.06±41.23, both P > 0.05]. The total effective rate of the Levosimendan group was obviously higher than that of the western control group [97.78% (88/90) vs. 78.89% (71/90), P < 0.05]. Conclusion Levosimendan can effectively improve the hemodynamics in patients with refractory heart failure, the elevation of patients' heart function, and the short-term therapeutic effect is very remarkable.