Comparison in clinical efficacy between levosimendan and milrinone in treatment of refractory heart failure

Bao Zhongwei; Wang Weiqun; Jiang Yan

doi:10.3969/j.issn.1674-4055.2017.10.29

Abstract：Objective To compare the clinical efficacy between levosimendan and milrinone in treatment of refractory heart failure (RHF).Methods RHF patients (n=66, male 32, female 34, aged from 44 to 89 and average age=61.10±16.08) were chosen from the Department of Cardiology of the People's Hospital of Tongzhou District of Nantong City from Dec. 2014 to Dec. 2016. All patients were divided, according to random digital table, into observation group (n=34) and control group (n=32). Based on the routine therapy of anti-RHF, control group was given milrinone injection and observation group was given levosimendan injection for one week. The levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected, and indexes of left ventricular ejection fraction (LVEF), left ventricular end-diastolic inner diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were detected by using echocardiogram in 2 groups before and after treatment. The grading of New York Heart Function Assessment (NYHA) was reviewed before and after treatment, clinical efficacy was reviewed after treatment, and adverse reactions were recorded during treatment period. Results The total effective rate was significantly higher in observation group than that in control group (79.41%vs. 53.13%, P<0.05) after treatment. In control group, there was 1 patients (3.13%) with NYHA grade Ⅱ, 14 (43.75%) with NYHA grade Ⅲ and 16 (50.00%) with NYHA grade Ⅳ after treatment. In observation group, there were 3 patients (8.82%) with NYHA grade Ⅱ, 23 (67.65%) with NYHA grade Ⅲ and 8 (23.53%) with NYHA grade Ⅳ after treatment. The improvement of NYHA grading was more significant in observation group than that in control group after treatment. The indexes of NT-proBNP, LVEF, LVEDD and LVESD were all improved in 2 groups after treatment, which was more significant in observation group (allP<0.05). The comparison in incidence of adverse reactions between 2 groups showed that the difference had no statistical significance (P>0.05).Conclusion The routine anti-RHF therapy combining levosimendan can effectively improve heart function, left ventricular remodeling and clinical efficacy in RHF patients, which is significantly superior to routine anti-RHF therapy combining milrinone.