Effects Of Early Intervention With Leosimendan On Patients With Subclinical Cardiac Dysfunction After Acute Myocardial Infarction

ObjectiveTo investigate the effect of early intervention with levosimendan on the improvement of cardiac function and prognosis in patients with subclinical cardiac dysfunction after acute myocardial infarction.MethodsA total of 40 patients with subclinical cardiac dysfunction after AMI admitted to our cardiovascular department in Taian City central hospital from January 2017 to August 2018were chosen and divided into experimental group and control group randomly,with 20patients in each group.Patients in both groups were treated with enteric-coated aspirin,statin,LMWH,ACEI/ARB,β-blockers and other conventional treatments,and revascularization by PCI was performed as early as possible.In addition to the above treatments,5ml of levosimendan was continuously injected intravenously for more than 20hours in the experimental group.The level of NT-pro BNP,hs-CRP and cTnI,along with LVEDd,LVEF and PAP were observed and compared between two group before and after treatment.The number of patients with clinical heart failure and needing endotracheal intubation and mortality during hospitalization was also recorded.ResultAfter treatment,NT-pro BNP,hs-CRP and cTnI in different groups were significantly lower than before(P<0.05),and the decrease of NT-pro BNP was more obvious in the experimental group(P<0.05).LVEF was significantly increased in the experimental group after treatment(P<0.05),while the differences in the control group were not statistically significant before and after treatment(P>0.05).The changes of LVEDd of the two groups showed no statistical significance before and after treatment(P>0.05).PAP in the experimental group decreased significantly after treatment(P<0.05),but in the control group there were still no statistically significant changes(P>0.05).The number of patients with clinical heart failure and needing intubation in the study group was lower than that in the control group(χ~2=3.13,P≤0.01),and no mortality was observed in either group.ConclusionEarly intervention with levosimendan can improve LVEF,reduce PAP and NT-pro BNP levels in plasma in patients with subclinical cardiac dysfunction after acute myocardial infarction.It can also reduce the rate of clinical heart failure and intubation rescue during hospitalization,which is of positive significance to the improvement of heart function.