Effect Observation Of Levosimendan On Heart Failure After Myocardial Infarction

Objective:To observe the efficacy and safety of Levosimendan Injection in the treatment of patients with heart failure after myocardial infarction.Methods : 80 patients with heart failure after myocardial infarction in hospital were randomly divided into control group(40 cases)and treatment group(40 cases).The treatment group was randomly divided into treatment group A(20 cases)and treatment group B(20 cases).The control group patients were given conventional treatment,including diuretic,vasodilator,plaque stability,inhibition of the renin angiotensin aldosterone system,so as to control the patient’s blood pressure,sodium restriction and limit at the water at the same time,to maintain the balance of water electrolyte and acid-base balance in patients,and then correct the arrhythmia patients,and give anti infection treatment.The treatment group patients were given levosimendan on the base of conventional treatment,the dose of 12.5mg,plus 5% glucose 45 ml with micro pump,the applied load of levosimendan was 12 ug / kg,injecting time was over 10 minutes,and 0.1 ug/(kg.min)pump in 1 hour,then gradually increased to 0.2 ug /(kg.min),while maintaining 24 hours in patient when given monitoring of blood pressure,heart rate,urine volume and ECG.The treatmen group A was given levosimendan once,the treatmen group B was given levosimendan first time as group A,second time after a week.Patient response was observed within 30-60 minutes of load and maintenance.If hypotension or tachycardia occured,the rate of infusion should be slowed or even discontinued.The clinical symptoms and signs,6 minutes walk test,the results of NT-pro BNP,left ventricular diastolic end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured and compared before and after treatment.Results : For each group of patients before treatment,the dyspnea score and body condition score,clinical 6min walking distance,the plasma level of NT-pro BNP,LVEDD and LVEF had no difference;after treatment,the dyspnea score and body condition score,clinical 6min walking distance,the plasma level of NT-pro BNP,LVEDD and LVEF were improved compared with before treatment,the difference was significant(P<0.05);at the same time,in the treatment group,dyspnea score and body condition score,clinical 6min walking distance,level of NT-pro BNP,LVEDD and LVEF were improved obviously compared with the control group,the difference was statistically significant(P<0.05);compared with group A,the improvement of the above indexes in group B was obvious,but the difference was not significant(P>0.05).Conclusion : Leosimendan treatment of heart failure after myocardial infarction(mi)could have good clinical curative effect.Leosimendan used again a week after it was used first time of heart failure after myocardial infarction could have better curative effect than it was used once.Leosimendan had good security.