| ObjectiveThe aim of this study was to analyze and investigate the efficacy of Levosimendan inpatients with acute heart failure (AHF, including acute onset of heart failure and acutedecompensated heart failure).MethodsA total of66AHF patients (NYHA III–IV or Killip III-IV) were equally assigned totwo groups:(1) the control group was given conventional anti-HF treatment includingcardiogram monitoring, oxygen inhalation, low-salt and low-fat diet, diuretics, cardiactonics, vasodilating agents, angiotensin converting enzyme Inhibitors (ACEI),angiotensin-receptor blockers (ARB) and β-blockers;(2) the Levosimendan group wasgiven Levosimendan in combination with conventional anti-HF treatment. The clinicaloutcomes were compared, and the levels of left ventricular ejection fraction (LVEF), strokevolume (SV), N-terminal of the prohormone brain natriuretic peptide (NT-proBNP),Norepinephrine (NE), interleukin-6(IL-6) as well as high-sensitivity C-reactive protein(hs-CRP) were measured before treatment and24h after treatment.Results1.There were no significant differences in the patients’ characteristics (age, sex, bodymass index, blood pressure etc.) and conventional medications (diuretics, cardiac tonics,vasodilating agents, ACEI etc.) between the control group and the Levosimendan group(P>0.05).2.The mean LVEF and SV24h after treatment with Levosimendan were higher thanthose before use of Levosimendan (LVEF40.95±8.99%vs29.13±8.11%, SV68.99±15.94mL vs58.51±15.95mL; both P<0.05).3.The mean LVEF24h after treatment in the control group was higher than that beforetreatment (35.13±7.94%vs28.79±7.99%, P<0.05); however, there was no significantdifference in the mean SV before and24h after treatment (62.45±18.65mL vs62.21±17.69 mL, P>0.05).4.The mean levels of NT-proBNP and NE were significantly decreased24h aftertreatment with Levosimendan compared with those before use of Levosimendan(NT-proBNP1268.64±213.66pg/mL vs2542.31±276.77pg/mL, NE142.6±68.12pg/mL vs201.8±75.34pg/mL; both P<0.05).5.The mean level of NT-proBNP24h after treatment in the control group wassignificantly decreased compared with that before treatment (1923.71±205.71pg/mL vs2433.31±265.74pg/mL, P<0.05); however, there was no significant difference in the meanNE before and24h after treatment (189.8±72.46pg/mL vs209.7±74.92pg/mL, P>0.05).6.The mean levels of IL-6and hs-CRP were significantly decreased24h aftertreatment with Levosimendan compared with those before use of Levosimendan (IL-620.36±5.00ng/L vs31.32±5.61ng/L, hs-CRP4.21±1.39mg/L vs8.13±1.54mg/L; bothP<0.05).7.The mean levels of IL-6and hs-CRP24h after treatment in the control group weresignificantly decreased compared with those before treatment (IL-626.54±5.21ng/L20.36±5.00ng/L vs32.01±5.34ng/L, hs-CRP5.99±1.09mg/L vs8.21±1.65mg/L; bothP<0.05).8.There were significant differences of LVEF、SV、NT-proBNP、NE、IL-6andhs-CRP after treatment between the control group and the Levosimendan group (P>0.05).Conclusions1.Levosimendan can significantly relieve the AHF patients’ clinical symptoms(dyspnea, palpitation) and improve cardiac contractility; therefore, LVEF and CO couldsignificantly increase.2.Levosimendan can significantly decrease the levels of NT-proBNP and NE,indicating it can inhibit the activation of neuroendocrine system under AHF condition andmyocardial remodeling.3.Levosimendan can significantly decrease the levels of IL-6and hs-CRP, suggesting itcan reduce the inflammatory reaction under AHF condition and improve the prognosis ofAHF patients. |
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