Clinical Effect Of Levosimendan And Qiliqiangxin Capsule In The Treatment Of Congestive Heart Failure

Objective:This study aims to evaluate the efficacy and safety of intravenious levosimendan and Qiliqiangxin capsule infusion on patients with decompensated CHF.I. Samples and Methods1. Samples60patients from Jinan3rd Hospital with decompensated CHF are enrolled in this study. Enrollment criteria are as follows:a. Symptoms listed in China Guidelines of Diagnosis and Treatment of Chronic Heart Failure (2007); b. With systolic dysfunction, NYHA level Ⅱ to Ⅳ; c. Left ventricutar ejection fraction ([LVEF]≤0.45). Meanwhile, patients with the following diseases are excluded:a. Severe primary heart valve disease, hypertrophic cardiomyopathy, restrictive cardiomyopathy, constrictive pericarditis and other cardiovascular diseases; b. Serious infection, electrolyte disorder, arrhythmia, hypotension, anemia, thyroid dysfunction; c. Liver and kidney disfunction; d. Hypersensitiveness or Contraindiction.2. Methods60patients with severe heart failure took pre-test examinations as blood and urine routine test, function of liver and kidney, heart rate, blood pressure and cardiac function indexes by Echocardiography. Patients were randomly and evenly divided into three groups (A, B and C). All patients were given conventional drug treatment of heart failure such as diuretics, ACEI or ARB, beta blockers, and avoiding taking any proprietary Chinese medicine by blood presser and heart rate. Group A was given conventional treatment; Group B differs from group A by adding leosimendan (qilu pharmaceutical co., LTD., specifications:5ml:12.5mg). Levosimendan starts at12ug/kg/min by vessel injection for10minutes. If patients do not have discomfort, injection is adjusted to0.1ug/(kg· min) for1hour and to0.15-0.2ug/(kg· min) for24hours. Group C differs from group B by adding Qiliqiangxin capsule (Shijiazhuang ridge pharmaceutical co., LTD., Authorisation No:Z20040141,0.3g/capsule), taken every1.2g3times a day. The examination lasts for two weeks for all three groups. Blood specimin is subsequently tested both24hours and second week after treatment. Echocardiography is used to measure left ventricular end-diastolic diameter (LVDDD), left ventricular ejection fraction (LVEF), measured using ultrasound speckle tracking imaging (STI) technology left for axis systolic maximum strain (GLS), to evaluate left ventricular myocardial strain capacity.This research adopts the electrochemical luminescence method to test plasma NT-proBNP level, strictly operates according to medicine provisions. All data processing is done using SPSS17.0statistical software. Measurement data are recorded using mean±standard deviation. T-test is adopted for two-sample mean test, variance test is applied on multi-sample mean test. Correlation test is done using Spearman analysis, with P<0.05indicating significance.II. Results1. Effectiveness ComparisonThe leosimendan group and the group with both levosimendan and Qiliqiangxin capsule group show a higher efficiency and total effective rate than the conventional group after treatment, while the latter show better treatment than the former.(p<0.05, p<0.01).2. Cardiac FunctionAll three groups have improved indicator level of cardiac function index LVEDD, LVEF, GLS NT-proBNP after treatment,6minWT distance is extended significantly. The differences show statistically significance (p<0.05, p<0.01),and heart function is improved for:group C> group B> group A (p<0.05, p<0.01).The length of time in hospetial is improved for:group C> group B> group A (p<0.05, p<0.01). The mortality of half a year is improved for:group C> group B> group A (p<0.05, p<0.01).3. Bad ReactionGroup A has1case of slight cough, without special treatment; group B has1case for low blood pressure and headache, which is relieved after slowing down the injection. No patients exits during the examination. No statistical significance (P>0.05) is found in the three groups.Ⅲ. Conclusion:1. Levosimendan injection can effectively decrease left ventricular end-diastolic volume and NT-proBNP in congestive heart failures, increase ejection fraction, increase the maximum strain left for shaft, and improve left ventricular systolic function.2. Levosimendan with QiLiQiangxin capsule can better reduce left ventricular end-diastolic volume and NT-proBNP, while improving left axial strain, left ventricular ejection fraction, myocardial remodeling, extending6minwt. They together improve heart function with moderate or severe congestive heart failure, improve life quality of patients, with safety, effectiveness and little bad reaction.