Effect of levosimendan on cardiac function and hemodynamics in patients with acute myocardial infarction and cardiogenic shock
10.3969/j.issn.1009-0754.2023.11.016
- VernacularTitle:左西孟旦对急性心肌梗死合并心源性休克患者心功能和血流动力学影响分析
- Author:
Jinzhou XIE
1
;
Lian LUO
;
Weijia CUI
;
Jing NING
Author Information
1. 610041 四川 成都,三六三医院心血管内科
- Keywords:
Levosimendan;
Acute myocardial infarction;
Cardiogenic shock;
Hemodynamics
- From:
Journal of Navy Medicine
2023;44(11):1179-1184
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effect of levosimendan on cardiac function and hemodynamics in patients with acute myocardial infarction and cardiogenic shock.Methods Totally 118 patients with acute myocardial infarction complicated with cardiogenic shock admitted to 363 Hospital were randomly assigned to control group or observation group,with 59 cases in each group.All the patients in both groups received routine treatment,and the observation group was given levosimendan additionally.The cardiac function indexes such as stroke volume(SV),cardiac index(CI),left ventricular ejection fraction(LVEF),and longitudinal peak systolic strain rate(SRs),the myocardial funtion indexes such as troponin I(cTnI),creatine kinase isoenzyme(CK-MB),vasopressin(AVP)and angiotensin(AngⅡ),hemodynamic parameters such as central venous pressure(CVP),pulmonary capillary wedge pressure(PCWP),mean arterial pressure(MAP),and left ventricular end-diastolic volume(LVEDV)were compared between the two groups before treatment and on day 3 after treatment.Shock duration,drug dose,time staying in intensive care unit(ICU),use of intra-aortic balloon counterpulsation(IABP),and incidence of malignant arrhythmia were also compared.Results There were no significant differences in all indexes between the two groups before treatment(P>0.05).On day 3 after treatment,SV,LEVF,CI,SRs,and MAP in the observation group were significantly higher than those in the control group(P<0.05),while AVP,AngⅡ,cTnI,CK-MB,CVP,PCWP,and LVEDV in the observation group were significantly lower than those in the control group(P<0.05).The duration of shock,the dosage of drugs,ICU time,and IABP time in the observation group were significantly lower than those in the control group(P<0.05).The incidence of malignant arrhythmia in the observation group was significantly lower than that in the control group(13.56%vs 28.81%,P<0.05).Conclusion Levosimendan can improve the hemodynamics of patients with acute myocardial infarction and cardiogenic shock.It has clinical application value.
