The efficacy of levosimendan and recombinant human brain natriuretic peptide in patients with acute myocardial infarction complicated with heart failure and its influence on brain natriuretic peptide and cardiac function

Qiu Hong; Chen Lin; Du Yingqiang; Ye Jiabao

doi:10.3760/j.issn.1673-4777.2025.12.003

Abstract：Objective To investigate the efficacy of levosimendan and recombinant human brain natriuretic peptide in patients with acute myocardial infarction(AMI)complicated with heart failure and its effect on brain natriuretic peptide(BNP)and cardiac function.Methods A total of 120 patients with AMI complicated with heart failure admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from January 2022 to January 2025 were selected,and they were divided into single-drug group(levosimendan treatment)and combination group(levosimendan combined with recombinant human brain natriuretic peptide treatment)by random number table method,with 60 cases in each group.The therapeutic effects,levels of cardiac troponin I(cTnI),BNP,soluble tumor suppressor protein 2(sST2),urotensin Ⅱ,interleukin-1β(IL-1β),matrix metalloproteinase 9(MMP-9),high sensitive C-reactive protein(hs-CRP),cyclophilin A,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and left ventricular ejection fraction(LVEF)were compared between the two groups.The adverse drug reactions of the two groups were analyzed.Results The total effective rate of the combination group was significantly higher than that of the single-drug group[93.3％(56/60)vs 80.0％(48/60)](P=0.032).After treatment,the levels of BNP,cTnI and sST2 in the two groups decreased,and the level of urotensin Ⅱ increased,and the comparison between the two groups showed that the combination group was better(all P＜0.05).After treatment,the levels of LVEDD and LVESD in the two groups reduced,and the level of LVEF increased,and the comparison between the two groups showed that the combination group was better(all P＜0.05).The levels of IL-1 β,MMP-9,hs-CRP and cyclophilin A in the two groups decreased after treatment,and the comparison between the two groups showed that the combination group was lower(all P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Levosi-mendan combined with recombinant human brain natriuretic peptide in the treatment of AMI complicated with heart failure can significantly reduce the level of BNP,improve the cardiac function of patients,alleviate the inflammatory response,improve the clinical efficacy,and has good safety.