Effect Of Levosimendan Combined With Recombinant Human Brain Natriuretic Peptide On Hemodynamics In Patients With Acute Decompensated Heart Failure

Objectives To investigate the hemodynamic effect of levosimendan combined with recombinant human brain natriuretic peptide(rh-BNP)on patients with acute decompensated heart failure(ADHF)by non-invasive cardiac output measurement system.Methods 60 patients with ADHF admitted to Department of Cardiology,Hebei Provincial People’s Hospital from August 2019 to December 2020 were randomly divided into control group and experimental group according to different treatment methods,30patients in each group.The control group was given rh-BNP besides conventional treatment,0.0075ug/kg/min intravenous micro-pumping continuously for 72 hours.On the basis treatment of the control group,the experimental group was given levosimendan,0.1ug/kg/min intravenous micro-pumping continuously for 24 hours.The changes of the non-invasive hemodynamic indexes including stroke volume(SV),stroke volume index(SVI),heart rate(HR),cardiac output(CO),cardiac index(CI),systolic arterial blood pressure(SABP),diastolic arterial blood pressure(DABP),mean arterial blood pressure(MABP),contractility index(CTI),ventricular ejection time(VET),early diastolic filling ratio(EDFR),left cardiac work index(LCWi),systemic vascular resistance index(SVRI),Systemic vascular resistance(SVR)before and 24 hours after treatment were compared between the two groups.The changes of the serological markers including hemoglobin(HGB),hematocrit(HCT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum potassium(K~+),serum sodium(Na~+),serum creatinine(Scr),blood urea nitrogen(BUN),N-terminal B-type natriuretic peptide(NT-pro BNP)before and 24 hours after treatment were compared between the two groups.The changes of the echocardiographic index such as left ventricular ejection fraction(LVEF)before and 10days after treatment were compared between the two groups.Adverse reactions in the course of treatment were recorded.Results 1 Comparison of the general and clinical data between the two groups,P>0.05,the difference was not statistically significant and comparable,thus,the two groups were comparable.2 SV,CO,CTI,LCWI after treatment in the experimental group were significantly higher than those in the control group,P<0.05,with significantly statistical differences;After treatment,the SVR level in the experimental group was significantly lower than that in the control group,P<0.05,with significantly statistical difference;NT-Pro BNP after treatment in the experimental group was significantly lower than that in the control group,P<0.05,with significantly statistical difference;Comparison of LVEF after treatment between the two groups,P>0.05,the difference was not significantly statistical.3 There were no significant differences in the liver function,renal function,electrolyte and incidence of adverse reactions between the two groups(P>0.05).Conclusions 1 Levosimendan combined rh-BNP therapy for patients with ADHF can significantly improve hemodynamic indexes with higher safety.2 The application of non-invasive cardiac output measurement system in patients with ADHF can obtain the hemodynamic indexes simply,quickly and accurately,and guide clinicians to treatment and effect observation.Figure 0;Table 10;Reference 136...