Safety and efficacy of levosimendan in patients with acute heart failure: a prospective, multicenter, and observational study
10.3760/cma.j.issn.1671-0282.2023.07.007
- VernacularTitle:左西孟旦用于急性心力衰竭的前瞻性多中心观察性研究
- Author:
Han ZHANG
1
;
Li JIANG
;
Rui FU
;
Ping QING
;
Xuan ZHANG
;
Tao TIAN
;
Yaoyao YANG
;
Guangxun FENG
;
Yanmin YANG
Author Information
1. 中国医学科学院阜外医院急诊中心，北京 100037
- Keywords:
Levosimendan;
Acute heart failure;
Efficacy;
Safety
- From:
Chinese Journal of Emergency Medicine
2023;32(7):889-894
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the indication, effectiveness, tolerance, and safety of levosimendan in patients with acute heart failure (AHF) in 20 hospitals in Beijing, China.Methods:This prospective, observational, and multicenter study consecutively enrolled AHF patients who were treated with levosimendan at 20 hospitals in Beijing from April 2020 to March 2022. Baseline demographics, laboratory parameters, clinical presentation, concomitant diseases and medications were collected. After initiation of levosimendan, levosimendan administration, laboratory parameter pre- and post-administration, symptoms improvement, and adverse events were also collected.Results:Totally 800 AHF patients were included, 67% of whom were male, aged (65 ±17) years, 50% of whom had ischemic heart disease, and the left ventricular ejection fraction (LVEF) was (36±11)%. The dose of levosimendan was (11.84 ±2.11) mg and the mean infusion time was (1 450±307) min. Dyspnea was improved in 83.4% of AHF patients at 24 h after treatment. The level of B-type natriuretic peptide (BNP) significantly decreased from 689 (406-1509) pg/mL to 410 (156-697) pg/mL in all patients at 24-72 h after treatment ( P<0.001), and the level of N-terminal pro-brain natriuretic peptide (NT-pro BNP) decreased from 6910 (3 715-13 914) pg/mL to 2 851 (1 288-6 191) pg/mL ( P<0.001). Meanwhile, LVEF level also improved significantly [(40±11)% vs. (36±11)%, P<0.001]. During levosimendan administration, adverse events occurred in 74 (9.3%) patients, including hypotension (5.9%), arrhythmia (1.9%), and other symptoms (1.1%). Among them, 7 patients ( 2 patients with hypotension and 5 patients with ventricular tachycardia) interrupted levosimendan administration. Conclusions:The use of levosimendan is safe, and can improve symptoms reduce BNP or NT-pro BNP levels and increase LVEF level in AHF patients.
