| Objective:To evaluate the clinical effects and safety of the combination of passive leg movement and intravenous 20mg furosemide in patients with acute decompensated chronic heart failure (CHF).Methods:62 acute decompensated CHF in-patients with II-IV NYHA class were studied, and randomly divided into the control group (Fs) and the combination group (PLM+Fs) on the basis of routine anti-heart failure treatments. Each group included 31 patients. After admission, medical history collection and physical examination were conducted, clinical data were recorded, and routine blood test and blood biochemical detection were done. The control group received intravenous 20mg furosemide, while the combination group received the combination of intravenous 20mg furosemide plus passive leg movement at 40 cycles per min for 20 minutes. The plasma N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels were detected by electrochemical luminescence method before and at 2 hours after treatments, respectively. At the same time, blood pressure (BP) and heart rate (HR) were measured by an electronic blood pressure monitor. The 2-hour urinary volume was measured by urinal. The usage of other anti-heart failure drugs and the infusion volume within the 2-hour period were also recorded. At the next day after admission, fasting blood glucose, blood lipid were detected and echocardiogram was performed. Then we observe the changes of these values including urinary volume, plasma NT-pro BNP levels, BP and HR before and after treatments, and compare their differences between two groups.Results:1. There were no significant differences in clinical characteristics (including gender ratio, age, BMI, duration of CHF, etiology, complications, NYHA class, fasting blood glucose, blood lipid, liver function, electrolytes, renal function, the parameters of echocardiogram), the usage of other anti-heart failure drugs and the infusion volume within the 2-hour period (P>0.05). So the two groups were comparable.2. In comparison with the control group, the 2-hour urinary volume in the combination group was significantly higher (808.39±521.26 ml vs 435.81±216.13 ml, P=0.000).3. The basic plasma NT-pro BNP levels were similar between two groups (4925.48±5066.92 pg/ml vs 4826.91±4019.29 pg/ml, P>0.05). In the control group, the NT-pro BNP level at 2 hours after treatments was slightly higher than that before treatments (5701.88±6067.82 pg/ml vs 4925.48±5066.92 pg/ml,P=0.143). But in the combination group, the NT-pro BNP level at 2 hours after treatments was significantly lower than that before treatments (3314.22±3764.87 pg/ml vs 4826.91±4019.29 pg/ml, P=0.000).4. The basic systolic blood pressure (140.77±27.67 mmHg vs 136.55±26.84 mmHg, P>0.05), diastolic blood pressure (79.97±16.31 mmHg vs 73.94±15.46 mmHg, P>0.05) and heart rate (86.48±16.97 beats/min vs 83.97±22.64 beats/min, P>0.05) were similar between two groups. Compared with those before treatments, all three values at 2 hours after treatments changed slightly in both groups, but the differences were not statistically significant (P>0.05).Conclusion:As for acute decompensated CHF patients, the combination of intravenous 20mg furosemide and passive leg movement enhances diuresis and decreases the plasma NT-pro BNP level without a significant change of BP and HR during the 2-hour period, so this combination therapy may safely and effectively be used in acute decompensated CHF patients. |
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