Effects of Levosimendan on myocardial ischemia and disease progression in patients with chronic heart failure
Objective To observe the effect of Levosimendan on myocardial function and disease progression in patients with chronic heart failure(CHF).Methods This study was a randomized controlled trial.A total of 125 CHF patients admitted to Zhengzhou Seventh People's Hospital from May 2020 to March 2023 were selected and were divided into a conventional group(62 cases)and a combined group(63 cases)by the computer grouping method.In the conventional group,there were 30 males and 32 females,the age was 52-78(65.44±5.18)years old,the course of CHF was 3-7(5.25±1.33)years,the cardiac function classification was grade Ⅱ in 33 cases and grade Ⅲin 29 cases,and the complications included hypertension in 35 cases and diabetes in 27 cases.There were 33 males and 30 females in the combined group,the age was 50-80(65.75±5.33)years old,the course of CHF was 4-6(5.31±1.28)years,the cardiac function classification was grade Ⅱ in 32 cases and grade Ⅲ in 31 cases,and the complications included hypertension in 38 cases and diabetes in 25 cases.The conventional group was treated with conventional medicine,and the combined group was treated with Levosimendan via intravenous injection combined with conventional medicine for 15 d.The changes in myocardial function[soluble growth stimulator expression gene 2 protein(sST2)and growth differentiation factor 15(GDF-15)],myocardial fibrosis indicators[connective tissue growth factor(CTGF),laminin(LN),and hyaluronic acid(HA)],and cardiac function indexes[left ventricular ejection fraction(LVEF),stroke output(SV),and cardiac output(CO)]before and after treatment,as well as occurrence of adverse cardiovascular events within 3 months after treatment and medication safety were compared between the two groups.Independent sample t test,paired t test,and x2 test were used.Results After treatment,the levels of sST2[(86.24±10.35)μg/L]and GDF-15[(814.36±50.25)ng/L]in the combined group were lower than those in the conventional group[(92.37±10.41)μg/L and(841.72±50.47)ng/L](both P＜0.05),the levels of CTGF[(1.04±0.52)μg/L],LN[(103.52±10.32)μg/L],and HA[(95.15±10.36)μg/L]in the combined group were lower than those in the conventional group[(1.77±0.36)μg/L,(110.75±10.25)μg/L,and(102.77±10.65)μg/L](all P＜0.05),and the levels of LVEF[(55.41±10.28)％],SV[(58.72±10.45)ml],and CO[(4.52±1.36)L/min]in the combined group were higher than those in the conventional group[(49.14±10.33)％,(52.33±10.06)ml,and(3.77±0.82)L/min](all P＜0.05).The total incidence of adverse cardiovascular events in the combined group[4.76％(3/63)]was lower than that in the conventional group[16.13％(10/62)](P＜0.05).There was no statistically significant difference in the total incidence of drug-related adverse reactions between the two groups(P＞0.05).Conclusions Levosimendan can effectively improve the myocardial function of CHF patients and delay the course of myocardial fibrosis.It has positive significance in promoting the patients'cardiac function recovery and reducing the risk of cardiovascular adverse events.Moreover,this drug has high safety and does not significantly increase the risk of drug-related adverse reactions.
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维普
