Influence of levosimendan on inflammatory markers and cardiac biomarkers in patients with acute heart failure
Zheng Ji-sha
Wang Chun-bin
Huang Qin
Zhang Lan-xin
Abstract：Objective To observe the influence of levosimendan on inflammatory markers and cardiac biomarkers in patients with acute heart failure (AHF). Methods Patients admitted to the Chengdu Third People's Hospital from April 2020 to March 2023 were selected as the research. According to the simplified random grouping (odd even number method),all patients were divided into a natriuretic peptide group (odd number) and an levosimendan group (even number),with 67 in each group. The patients in the natri-uretic peptide group were given intravenous pump of rhBNP,and those in the levosimendan group were given levosimendan based on the regimen in the natriuretic peptide group for 24 hours. The treatment course of both groups lasted for 1 week. Before and after treatment,the cardiac function indicators (left ventricular ejection fraction (LVEF),stroke volume (SV)),coronary circulation hemo-dynamic indicators (tricuspid regurgitation velocity (TRmax),central venous pressure (CVP)),inflammatory markers (interleukin-6 (IL-6),procalcitonin (PCT)),cardiac biological markers (cardiac troponin (cTnT),B-type natriuretic peptide (BNP)),in-hospital mor-tality and readmission rate within 30 days and incidence of adverse reactions were compared between the two groups. Results Af-ter treatment,LVEF values in the levosimendan group and natriuretic peptide group were (52.21±6.34)％ and (48.31±6.89)％,and SV values were (55.32±3.78) mL and (51.45±3.57) mL,which were enhanced as compared with those before treatment,and the dif-ferences between the two groups were statistically significant (t=3.409,6.093,P<0.05). The TRmax values in the levosimendan group and natriuretic peptide group after treatment were (2.02±0.20) m·s-1 and (2.16±0.22) m·s-1,and the TRmax was declined than that be-fore treatment,and there was a statistical significance between the two groups (t=3.854,P<0.05). The CVP values in the levosimendan group and natriuretic peptide group were (6.02±1.30) mm Hg (1 mmHg ≈ 0.133 kPa) and (6.84±1.49) mm Hg,which were decreased as compared with those before treatment,and the difference was statistically significant between the two groups (t=3.394,P<0.05). The levels of IL-6 were (35.15±4.53) ng·L-1 and (40.35±5.32) ng·L-1,and the levels of PCT were (40.35±5.32) μg·L-1 and (3.78±0.63) μg·L-1,which were reduced as compared with those before treatment,and there were statistically significant differences in IL-6 and PCT levels between the two groups (t=6.092,3.255,P<0.05). The cTnT levels in the levosimendan group and natriuretic peptide group after treatment were (74.35±5.49) pg·mL-1 and (81.41±8.54) pg·mL-1,and BNP levels were (91.47±18.25) ng·mL-1 and (136.07±24.93) ng·mL-1,which were decreased as compared with those before treatment,and there were statistical differences between the two groups (x2=0.208,2.978,P=0.649,0.084). The in-hospital mortality rates were 2.30％ and 3.53％,and the readmis-sion rates within 30 days were 2.30％ and 8.24％ respectively (x2=0.085,P=0.770). The incidence of adverse reactions was 8.05％ in the levosimendan group and 7.06％ in the natriuretic peptide group. Conclusion The application of levosimendan combined with rhBNP in patients with AHF is beneficial for improving the cardiac function,promoting the coronary circulation and inhibiting the myocardial fibrosis,and its effect has obvious advantages over rhBNP.
Keywords：Acute heart failureLevosimendanNatriuretic peptideMyocardial fibrosisAdverse reaction
Publication Date：2024-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 695-698,712 )