Efficacy and safety of levosimendan combined with esmolol in treatment of patients with acute decompensated heart failure

Kuang Shan; Cheng Yixing; Chi Yongsheng; Zhang Chunni

doi:10.3969/j.issn.1672-8157.2025.04.008

Abstract：Objective To explore the efficacy and safety of levosimendan combined with esmolol in treatment of patients with acute decompensated heart failure(ADHF).Methods The clinical data were collected from 108 patients with ADHF who were treated in the Huzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from Jan-uary 2021 to January 2025 and were retrospectively analyzed.The patients were grouped according to different treatment methods.Patients who were treated with levosimendan were included in the levosimendan group(50 cases)and patients who received levo-simendan combined with esmolol were enrolled as the combined group(58 cases),and both groups were treated for 7 days.The clinical efficacy was observed in both groups;the left ventricular function[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD)],tricuspid annular plane systolic excursion(TAPSE)and coagulation function indexes(coagulation factor reaction time and coagulation complex index)were observed and compared between the two groups before and after treat-ment,and the adverse reactions of the two groups during treatment were recorded.Results The total effective rate of the combined group was 93.10% (54/58),higher than 76.00% of the levosimendan group(χ2=6.224,P<0.05).The LVEF and TAPSE of the two groups were higher after the treatment than before the treatment,while the LVESD,coagulation factor reaction time and coagulation complex index were lower after the treatment than before the treatment.The LVEF and TAPSE of the combined group were respec-tively(49.87±6.19)% and(18.12±2.45)mm,higher than(46.11±6.78)% and(16.56±3.09)mm of the levosimendan group(t=3.012,2.924,P<0.05),while the LVESD,coagulation factor reaction time and coagulation complex index of the combined group were respectively(47.73±4.45)mm,(4.87±1.33)min and(1.18±0.25),lower than(50.12±4.87)mm,(6.01±1.01)min and(1.45±0.27)of the levosimendan group(t=2.998,4.953,5.393,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.870,P>0.05).Conclusion Levosimendan combined with esmolol has significant efficacy in the treatment of ADHF,and it can effectively enhance the cardiac function and improve the coagulation status,with the safety favorable.