Levosimendan Improves Clinical Outcomes of Refractory Heart Failure in Elderly Chinese Patients.
BACKGROUND
Levosimendan has been extensively used to treat heart failure (HF) for nearly 10 years, but data on levosimendan used in elderly patients with refractory HF remains limited. This study aimed to investigate the effects of levosimendan on elderly patients with intractable HF.


METHODS
A total of 268 patients with HF (over 70 years, New York Heart Association [NYHA] classification III-IV, LVEF ≤40%, plasma NT-proBNP ≥1000 pg/mL) received conventional anti-HF therapies for 2 weeks. Such therapies include the limiting of salt intake, increasing myocardial contractility (without levosimendan), inducing urine, antagonizing aldosterone, antagonizing myocardial remodeling, and, if necessary, using antibiotics. Our study included 42 patients without symptoms whose improvement was re-evaluated and presented in NYHA class III-IV, LVEF ≤40%, plasma NT-proBNP ≥1000.0 pg/mL, and serum creatinine <110.0 µmol/L. These patients were divided into an experimental groups (n=21, treated with levosimendan) and a control group (n=21, continuously given regular treatment as before). After 1 week, 42 patients were assessed for changes in NYHA classification, LVEF, and NT-proBNP.


RESULTS
No severe complications related to levosimendan were noted. Compared with the control group, NYHA classification (I-II: 1 versus 21, III-IV: 20 versus 0, P<0.05) and LVEF (30.62±6.19% versus 45.83±5.06%, P<0.05) were increased, and plasma NT-proBNP was reduced (458.35±193.16 pg/mL versus 2921.52±1395.97 pg/mL, P<0.05) in the experimental group.


CONCLUSIONS
Our study showed levosimendan significantly and safely improved clinical outcomes of refractory heart failure in elderly patients.
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).
Dengqing
D
Zhang
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).
Yuanqing
Y
Yao
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).
Jun
J
Qian
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China (mainland).
Jing
J
Huang
D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D044466:Asian People; D002681:China; D003404:Creatinine / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011446:Prospective Studies; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan; D013318:Stroke Volume / Q000187:drug effects; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D006835:Hydrazones; D010446:Peptide Fragments; D011724:Pyridazines; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000077464:Simendan; D003404:Creatinine