OBJECTIVES: Levosimendan,recombinant human brain natriuretic peptide(rh BNP)and milrinone was adopted to treat ADHF patients respectively.The objective is to evaluate the efficacy and safety of three intravenous drugs.METHODS: 60 patients with ADHF were consecutively enrolled into this study from August 2013 to March 2015 randomly,which were divided into three groups(median 162 d follow-up).All the patients received standard anti-heart-failure therapy combined with levosimendan(n = 30),rh BNP(n = 15),milrinone(n = 15)respectively.Baseline datas,the change of hemodynamic conditions,the classification of cardiac function,followed up for the change of NT-pro BNP concentrations and echocardiographic index between groups after the treatments were collected.Besides the adverse effects,follow-up long-term prognosis in patients with 3 groups were recorded.RESULTS: Baseline characteristics,cardiac biomarkers of heart failure,echocardiographic index and drugs were similar between the three groups(P>0.05).There are statistical significance in blood pressures,heart rates and NYHA cardiac function grading in three groups after the treatments(P<0.05),but no differences between groups.The drop-out value of NT-pro BNP after treatment was significantly different between levosimendan group and milrinone group(P=0.047).Meanwile six months follow-up of patients’ s LVEF between levosimendan,milrinone and rh BNP,milrinone was remarkably different(P=0.023,P=0.022 respectively).The adverse events were not significantly different(P > 0.05).Compared with milrinone group,levosimendan group had a better prognosis(P = 0.005).CONCLUSIONS:1.All three intravenous drugs(levosimendan,rh BNP,milrinone)can improve hemodynamics in patients with decompensated conditions and alleviate the symptoms of ADHF patients.2.Levosimendan reduces the concentration of NT-pro BNP,improves cardiac systolic function with less adverse effects in ADHF patients.Compared with traditional positive inotropic drugs,it extends the event free time among heart failure patients. |