Therapeutic effects of levosimendan combined with lyophilized recombinant human brain natriuretic peptide on senile ischemic cardiomyopathy complicated by heart failure

doi:10.3969/j.issn.1002-7386.2018.14.012

Abstract：Objective To investigate the clinical effects of levosimendan combined with lyophilization of recombinant human brain natriuretic peptide in treatment of senile ischemic cardiomyopathy complicated by heart failure. Methods A total of 120 patients with acute decompensated heart failure due to ischemic cardiomyopathy ( echocardiographic left ventricular ejection fraction≤40% ) who were admitted and treated in our hospital from June 2015 to December 2016 were enrolled in the study. According to the random number table method,these patients were divided into control group,observation group 1, observation group 2 and observation group 3, with 30 cases in each group. The patients in control group were treated by conventional basic drugs,on this basis, the patients in observation group 1 were treated by levosimendan,and the patients in observation group 2 were treated by lyophilized recombinant human brain natriuretic peptide, however, the patients in observation group 3 were treated by levosimendan combined with lyophilized recombinant human brain natriuretic peptide. After 3-day treatment, the therapeutic effects, left heart function indexes imcluding LVEDD,SV,CI and LVEF, the other indexes levels including hs-CRP,NT-proBNP and CysC,and vital signs including HR,RR,SBP,SaO2were observed and compared among the four groups. Results The effective rate in observation group 3 was 93. 33% , which was significantly higher than that (80% ) in observation group 2 and that (76. 67% ) in observation group 1 as well as that (70% ) in control group (P<0. 05). Before treatment there were no significant differences in the levels of LVEDD, SV, CI and LVEF among the four groups (P >0. 05). After treatment, the levels of LVEDD, SV, CI, and LVEF were significantly increased in the four groups,moreover,the the levels of these indexes in observation group 3 were significantly higher than those in control group (P<0. 05). After treatment the average urine volume was increased in the four groups,moreover,the increase degree in observation group 3 was more significant (P<0. 05). In addition after treatment the levels of NT-proBNP, hs-CRP, and CysC were decreased in the four groups,as compared with those before treatment,moreover,which in observation group 3 were significantly lower than those in control group (P< 0. 05). Before treatment there were no significant differences in the levels of HR, RR, SBP and SaO2among the four groups (P>0. 05). After treatment,the levels of HR, RR, SBP and SaO2in observation group 3 were significantly improved,as compared with those in the other three groups ( P < 0. 05 ). Conclusion The levosimendan combined with lyophilized recombinant human brain natriuretic peptide has obvious therapeutic effects on senile refractory ischemic cardiomyopathy complicated by heart failure, which can promote the improvement of cardiac function, inhibit ventricular remodeling, and reduce the levels myocardial injury markers,therefor,which has an active clinical significance.