Effect of levosimendan combined with cyclic adenosine monophosphate on elderly patients with acute left heart failure
Objective To explore the impact of levosimendan combined with cyclic adenosine monophosphate(cAMP)on the ventricular remodeling and levels of serum cardiac troponin Ⅰ(TnⅠ)and transient receptor potential channel 1(TRPC1)in elderly patients with acute left heart failure.Methods Ninety-six elderly patients diagnosed with acute left heart failure in Hancheng People's Hospital from June 2022 to November 2023 were selected and were divided into an observation group and a control group by the envelope method with 48 patients in each group,in a prospective study.In the observation group,there were 25 males and 23 females;the age was(76.97±5.23)years old;the body mass index was(25.35±2.79)kg/m2;the cardiac function classification was grade Ⅲ in 30 cases and grade Ⅳ in 18 cases.In the control group,there were 26 males and 22 females;the age was(77.41±5.16)years old;the body mass index was(25.14±2.62)kg/m2;the cardiac function classification was grade Ⅲ in 31 cases and grade Ⅳ in 17 cases.Both groups received conventional interventions such as diuretics,cardiotonics,and vasodilators.The control group was treated with intravenous drip with cAMP,and the observation group received intravenous drip with levosimendan and cAMP for a treatment period of 7 days.The clinical efficacy,ventricular remodeling indexes[interventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),and left ventricular mass index(LVMI)],cardiac reserve function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),and left ventricular end-diastolic diameter(LVEDD)],serum TnⅠ and TRPC1 levels,and incidence of adverse reactions were compared between the two groups.Independent sample t test,paired sample t test,and x2 test were used.Results After treatment,the total effective rate of the observation group[91.67％(44/48)]was higher than that of the control group[75.00％(36/48)](P＜0.05).After treatment,the ventricular remodeling indexes in the observation group were better than those in the control group[IVST:(7.45±0.82)mm vs.(9.04±1.11)mm,LVPWT:(8.09±0.84)mm vs.(8.89± 1.07)mm,LVMI:(112.67±15.12)g/m2 vs.(120.21±16.83)g/m2](all P＜0.05).After treatment,the LVEF of the observation group was higher than that of the control group[(56.32±6.01)％vs.(51.78± 5.90)％],but the LVESD and LVEDD were lower than those of the control group[(50.27±5.98)mm vs.(59.46±6.24)mm,(53.92±7.47)mm vs.(62.85±7.22)mm](all P＜0.05).After treatment,the serum TnⅠ and TRPC1 levels in the observation group were lower than those in the control group[(0.34± 0.06)μg/L vs.(0.46±5.90)μg/L,(8.25±1.62)ng/L vs.(13.27±2.07)ng/L](both P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the observation group[16.67％(8/48)]and the control group[14.58％(7/48)](P＞0.05).Conclusion Levosimendan combined with cAMP effectively improves the ventricular remodeling,enhances the cardiac function,and reduces the serum levels of TnⅠ and TRPC1 in elderly patients with acute left heart failure,benefiting the recovery treatment of left heart failure patients.
LevosimendanCyclic adenosine monophosphateElderlyAcute left heart failureVentricular remodelingTnⅠTRPC1
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