Efficacy And Mechanism Of Levosimendan In Patients With Coronary Heart Disease With Moderate Or Severe Cardiac Dysfunction

Objective: To evaluate objectively clinical effects of levosimendan on treatment of severe heart failure of coronary heart disease and the effects on CaN/NFAT3 signaling pathway and apoptosis protein.Method:Taking the currently accepted treatment of severe heart failure as a control,we carried out a prospective,randomized and controlled clinical study.Cases included in this study were randomly divided into control group and treatment group.Cases of control group received basic therapy and cases of treatment group received basic therapy plus levosimendan for 24 hours.After 5 days,we observed the changes in Minnesota Satisfaction Questionnaire Scales,ultrasound cardiogram and serum indexes of patients with severe heart failure before and after treatment.Result:(1)Comparison of scores of Minnesota Satisfaction Questionnaire Scale: after treatment,scores of two groups had a significantly lower,and comparing with before treatment,the difference was statistically significant(P<0.05).Scores of treatment group decreased more significantly than that of control group(P<0.05).(2)Comparison of curative effect on ultrasound cardiogram showed that after treatment,changes of LVEF and LVFS of two groups had a statistically significant comparing with before treatment(P<0.05).Changes of LVEF and LVFS of treatment group increased more significantly than that of control group(P<0.05).(3)Comparison of serum NT-proBNP: after treatment,changes of two groups had a significantly lower,and comparing with before treatment,the difference was statistically significant(P<0.05).Changes of treatment group decreased more significantly than that of control group(P<0.05).(4)Comparison of serum CaN?P-NFAT3?NFAT3: after treatment,changes of two groups had a significantly lower,and comparing with before treatment,the difference was statistically significant(P<0.05).Changes of treatment group decreased more significantly than that of control group(P<0.05).(5)Comparison of serum Bax?Bcl-2: after treatment,two groups had a significantly changes comparing with before treatment(P<0.05).Changes of treatment group altered more significantly than that of control group(P<0.05).Conclusion:Levosimendan can improve the quality of life and improve hear t function in patients with moderate to severe heart failure on the basis of co nventional treatment.The mechanism may be related to the inhibition of Ca N/NFAT3 and the reduction of myocardial apoptosis.