Comparison of Therapeutic Efficacy among Levosimendan,Milrinone and Dobutamine in Treatment of Acute Heart Failure

Zhang Xiaojuan; Li Bao; Wang Jingping

doi:10.3969/j.issn.16721349.2015.05.025

Abstract：Objective To compare the curative effects of levosimendan,milrinone and dobutamine in treatment of acute heart failure (AHF),and to probe the impacts of heart function,neurohormone factors levels and security.Methods Ninety patients with AHF were randomized into three therapy groups:Milrinone group,dobutamine group and levosimendan group.The clinical effects,left ven-tricular internal diameter at end diastole(LVIDd),left ventricular ejection fraction(LVEF)and fractional shortening(FS)changes,B type natriuretic peptide precursor (NT proBNP),endothelin 1(ET 1),norepinephrine(NE)levels were observed.Results After 24 hours of treatment,total effective rate was higher in levosimendan group than other two groups(P= 0.004,0.015).Levosimen-dan group patients systemic clinical conditions were improved markedly.After 7 days of treatment,LVIDd,LVEF and FS of three groups were better than not treatment(P<0.01).In levosimendan group,LVIDd was not reduced than other groups(P= 0.113), but LVEF and FS were increased(P<0.01).In three groups,serum NT proBNP levels decreased 24 hours and 7 days after treat-ment than baseline(P<0.01),and the level furtherly reduced 7 days after treatment than 24 hours(P<0.01).After 7 days treat-ment,serum NT proBNP of levosimendan group reduced markedly than other groups(P= 0.006,0.003).Serum ET 1 and NE levels of three groups 7 days after treatment reduced than baseline(P<0.01).After 7 days treatment,serum NE of levosimendan group reduced markedly than other groups(P<0.017),In levosimendan group,rehospitalization rate was significantly lower than other groups(P= 0.005,0.013).Conclusion Levosimendan can significantly improve the clinical symptoms in patients with AHF than milrinone and dobutamine,gradual y improve cardiac systolic function,reduce rehospitalization rate.