Effect of levosimendan combined with Shenfu injection on hemodynamics monitored by pulse-indicator continuous cardiac output in patients with heart failure with reduced ejection fraction
He Gang
Liu Hongxu
Zhou Qi
Tian Wei
Lai Xiaolei
Tong Tong
Zhou Ying
Abstract：Objective To investigate the effect of levosimendan combined with Shenfu injection on hemodynamics, which is observed by pulse-indicator continuous cardiac output( PICCO) monitoring technique in patients with heart failure with reduced ejection fraction(HFrEF). Methods From September 2016 to November 2018, 32 HFrEF patients admitted to the cardiac intensive care unit of Beijing Hospital of Traditional Chinese Medicine, Capital Medical University were monitored by PICCO technology. The patients were treated with levosimendan and Shenfu injection. Hemodynamic indexes including invasive arterial pressure [ systolic blood pressure, diastolic blood pressure and invasive mean blood pressure( IMBP) ] , heart rate, cardiac output index, stroke output index ( SVI) , systemic vascular resistance index( SVRI) and intra-thoracic blood volume index( ITBI) were observed at 0, 2, 24 h after treatment. Results Systolic blood pressure, diastolic blood pressure and IMBP at 24 h after medication were significantly higher than those at 0 h[(115 ±14)mmHg vs (93 ±11)mmHg, (72 ±8)mmHg vs (45 ±5)mmHg, (86 ±11)mmHg vs (61 ±8)mmHg](all P<0.05). Heart rate significantly increased at 2 h [(121 ±14)times/min] and decreased at 24 h[(109 ± 13)times/min] compared with that at 0 h[(115 ± 13)times/min](all P<0. 05). At 2, 24 h after medication, cardiac output index and SVI were significantly higher thanthoseat0h[(2.6±0.9),(3.7±1.4)L/(min·m2) vs(2.1±0.6)L/(min·m2); (24.8±3.2), (37.9±3.8)ml/m2vs(20.7±2.7)ml/m2]; SVRIwassignificantlylowerthanthatat0h[(2669±169), (2826 ±174)dyn·sec·m2/cm5 vs (3820 ±213)dyn·sec·m2/cm5](all P<0. 05). There were no significant changes of ITBI at 0, 2, 24 h after treatment(all P>0.05). Conclusions Levosimendan combined with Shenfu injection treating HFrEF patients can improve blood pressure and myocardial contractility, increase cardiac output and reduce cardiac afterload. It can also effectively prevent hypotension at the beginning of medication. With PICCO monitoring, levosimendan combined with Shenfu injection shows good therapeutic efficacy and few side effects, which suggests the feasibility and practicability of the combination regimen in clinical practice.
Keywords：Heart failureHemodynamicsLevosimendanShenfu injection
Publication Date：2020-04-08
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 508-512 )