Short-term efficacy of levosimendan combining recombinant human brain natriuretic peptide on heart ;failure after old myocardial infarction
TIAN Hong-zhen
CHEN Jiang
SUN Zhi-jun
CHEN Guang-hui
Abstract：Objective To observe the curative effect and safety of levosimendan combining recombinant human brain natriuretic peptide (rhBNP) on heart failure after old myocardial infarction (OMI). Methods The patients (n=60, male 39, female 21, aged from 49 to 78 and average age=68.2±13.1) were chosen from Dec. 2012 to Jun. 2014. All patients were randomly divided into control group and treatment group (each n=30). Besides of basic therapy was given to 2 groups, control group was additionally given levosimendan and treatment group was given levosimendan and rh-BNP. The hemodynamic indexes including cardiac output (CO), cardiac index (CI), intrathoracic blood volume index (ITBVI) and extravascular lung water index (EVLWI) were monitored with pulse-indicated continuous cardiac output (PiCCO). The levels of LVEF, LVEDd and brain natriuretic peptide (BNP) were detected and heart function was reviewed by using 6-minute walk test (6MWT) before and 7 d after treatment, and incidence of adverse reactions were observed. Results The levels of CO and CI increased significantly and ITBVI and EVLWI decreased significantly in 2 groups 72 h after treatment (all P<0.05). In treatment group, CO [(4.43±0.36) L/min vs. (3.44±0.13) L/min], CI [(4.57±0.64) L/min·m2 vs. (3.45±0.24) L/min·m2], ITBVI [0.72±0.08) L·m2 vs. (0.96±0.07) L·m2], and EVLWI [(5.70±0.32) mL/kg vs. (7.39±0.76) mL/kg] were better significantly than those in control group (all P<0.05). The fluid in-put and out-put volume was significantly more in treatment group than that in control group (P<0.05). The levels of LVEF and 6MWD increased significantly, and LVEDD and BNP decreased significantly in 2 group 7 d after treatment (all P<0.05). After treatment, LVEF [(36.71±3.24)%vs. (39.51±3.19)%] and 6MWD [(236.75± 58.39) m vs. (267.94±42.13) m] increased, and LVEDD [(54.3±2.4) mm vs. (51.6±3.8) mm] and BNP [(2936.81±1052.47) pg/mL vs. (2438.65±824.2) pg/mL] decreased in treatment group compared with control group (all P<0.05). The incidence of adverse reactions had no statistical difference between 2 groups (P>0.05). Conclusion Levosimendan combining rhBNP is superior to single levosimendan in improve hemodynamics and heart function in patients with heart failure after OMI with higher safety.
Keywords：Myocardial infarctionHeart failureLevosimendanRecombinant human brain natriuretic peptidePulse-indicated continuous cardiac outputSix-minute walk test
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 776-779 )