Efficacy And Safety Of Levosimendan In Acute Exacerbation Of Chronic Heart Failure Patients With Reduced Ejection Fraction

Objective:To observe the short-term efficacy and safety of levosimendan in acute exacerbation of chronic heart failure patients with reduced ejection fraction.Methods:Total of 49 patients with acute exacerbation of chronic heart failure with reduced ejection fraction were randomly divided into experimental group(26cases),the control group(23 cases).The control group only received standard heart failure medications;the experimental group received levosimendan injection in addition to the same routine treatment.The observation indexes are as follows:The N terminal B type natriuretic peptide(NT-Pro BNP),blood potassium(K~+),hemoglobin(HGB),hematocrit(HCT)and creatinine(Cr)before and 48 hours after medication;echocardiographic examination of LVEF and LVEDD before and 7 days after medication,New York Heart Association(NYHA)classification before and 7 days after medication;the incidence of adverse cardiac events during the treatment;rehospitalization rates of patients within a month.The data were statistically analyzed with SPSS 17 statistical software,and P-value<0.05 was ragarded as statistically significant.Result:1.There were no significant differences in the general clinical data of the two groups.The laboratory assessments including NT-Pro BNP,K~+,HGB,HCT and Cr showed no significant differences between two groups before treatment,also as NYHA heart function classification and echocardiography assessment indexes before treatment.2.Comparison of efficacy:After treatment,NT-Pro BNP level of experimental group was significantly lower than the control group and LVEF level of experimental group was significantly higher than the control group.After treatment,LVEDD of experimental group was significantly decreased compared with baseline,same as the control group compared with baseline,but there was no significant difference in LVEDD level between the two groups.Chi-Square test showed the treatment efficacy of the experimental group was significant better than the control group.3.Security comparison:There were no significant differences in blood potassium(K~+),hemoglobin(HGB),hematocrit(HCT)and creatinine(Cr)between the experimental group and the control group before and 48 hours after the treatment.In the process of observation and treatment,there was no significant difference in the adverse events between the two groups.4.The comparison between two groups of patients in the re-admission rate within a month:there was no significant difference in the re-hospitalization rate between the two groups.Conclusion:For acute exacerbation of chronic heart failure patients with reduced ejection fraction,levosimendan treatment could improve NT-Pro BNP level,LVEF and LVEDD,so as to ameliorate NYHA cardiac function grading without adverse cardiovascular events and reactions.Therefore,levosimendan is an effective and safe treatment for acute exacerbation of chronic heart failure patients with reduced ejection fraction.