Author + information
- Tongshe Li,
- Zhenhua Gao,
- Zhihong Yang and
- Feipeng Jin
To discuss the therapeutic efficacy of levosimendan injection in treating elderly patients with Severe Decompensated Heart Failure.
64 cases of senile CHF patients from January 2015 to January 2016 in our hospital were selected and randomly divided into levosimendan group and basic treatment group, 32 cases in each group. Basic treatment group 17 males and 15 females, aged (74±4.1) years; levosimendan group of 16 males and 16 females, aged (69±5.7) years. The two groups was not statistically significant between gender, age and refractory heart failure clinical symptoms and signs. All groups were given Digitalis, ACEI, spi-rolactone, furosemidum, trimetazidine and other comprehensive treatment; and levosimendan group was given levosimendan injection [0.1 μg/(kg·min)] for consecutive 24 h based on regular treatment. Blood pressure, heart rate, dyspnea, the improvement of systemic clinical symptoms and 24 h urine volume were observed in both groups before and 7d after treatment. The venous blood samples were collected to determine the change of Na+, K+, renal function, PROBNP and other related indicators; the changes of LVEDd, LVESd, LVEF, CI and other indicators were determined by UCG. Statistical data processing using SPSS 19.0 statistical software. Measurement data with x±s that the groups were compared using t test. Count data with the number of cases and percentages, compared with X2 test. P < 0.05 was considered statistically significant.
Compared with before treatment, after treatment 7d, 2 groups of patients with left ventricular end-diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd) were significantly decreased left ventricular ejection fraction (LVEF), cardiac index (CI) were significantly increased, the difference was statistically significant (P <0.05). 7 days after administration, compared with basic treatment group, the blood pressure, heart rate, BNP, LVEDd and LVESd of levosimendan group decreased significantly, while dyspnea, systemic clinical symptoms and LVEF were improved significantly, and 24 h urine volume and CI increased significantly, with statistical significance (P < 0.05). The overall response rate of levosimendan group (72.6%) was higher than basic treatment group (68.3%), the difference was statistically significant (P < 0.05). There were no serious adverse events in both groups.
Levosimendan is a new calcium sensitizer on myocardial ischemia and reperfusion injury have a protective effect. Levosimendan may also reduce the load by dilation of blood vessels around the heart, increase cardiac index without increasing myocardial oxygen consumption. Levosimendan injection treating elderly patients with chronic heart failure, improves therapeutic efficacy with high safety. A limitation of this study is that the small number of samples, to observe a short time, not long-term efficacy of patients and follow-up monitoring of the laboratory tests, the long-term efficacy of levosimendan still need a lot of evidence based medicine further clarified in the future.