Abstract 【Objective】To explore the clinical efficacy of levosimendan combined with tofacilitan in patients with acute decompensated ejection fraction preserved heart failure (HFpEF). 【Methods】A total of 78 patients with acute decompensated HFpEF admitted to Shaanxi Aerospace Hospital from March 2020 to November 2021 were selected and randomly divided into an observation group and a control group using a random number table method, with 39 cases in each group. The control group was treated with Tovastatin tablets, while the observation group was treated with a combination of levosimendan on the basis of the control group. Both groups of patients were evaluated for cardiac function indicators [left ventricular end diastolic/systolic diameter (LVEDD/LVESD) and left ventricular ejection fraction (LVEF)], myocardial injury related indicators [heart type fatty acid binding protein (hFABP) and N-terminal B-type brain natriuretic peptide(NT-proBNP)], and cardiac function related inflammatory factor indicators [high-sensitivity C-reactive protein (hs-CRP) and hypoxia inducible factor 1α (HIF-1α)] before and 1 week after treatment Hemodynamic indicators [heart rate (HR), stroke output (SV)] and 24-hour urine output levels, and adverse drug reactions were recorded.【Results】After treatment, LVEDD and LVESD in both groups were lower than before treatment, and LVEF was higher than before treatment. LVEDD and LVESD in the observation group were lower than those in the control group, and LVEF was higher than those in the control group, with statistical significance (P<0.05); The serum levels of hFABP, NT-proBNP, hs-CRP, and HIF-1α in two groups of patients were lower than before treatment, and the observation group was lower than the control group (P<0.05); The SV and 24-hour urine output of the two groups of patients were higher than before treatment, while the HR was lower than before treatment. The observation group had higher SV and 24-hour urine output than the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the observation group and the control group (P>0.05). 【Conclusion】The combined use of levosimendan and tofapetam in the treatment of acute decompensated HFpEF patients is beneficial for the recovery of cardiac function, stable hemodynamics, and good safety.
MA Rui,LEI Xueting. The Effect of Levosimendan Combined with Tofacilitaxel in the Treatment of Acute Decompensated HFpEF[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(12): 1936-1939.
[1] SIMMONDS S J, CUIJPERS I, HEYMANS S, et al. Cellular and molecular differences between HFpEF and HFrEF: A step ahead in an improved pathological understanding[J].Cells,2020,9(1):242. [2] 孟海娜,谢嘉怡,何微. 托伐普坦治疗慢性心力衰竭合并低钠血症的效果[J].中国医科大学学报,2019,48(6):551-554. [3] 孙飞,王海珠,刘丹丹,等. 左西孟旦对老年急性心力衰竭患者心脏功能MACE事件及不良反应的影响[J].安徽医学,2019,40(6):621-624. [4] 中国医师协会急诊医师分会,中国心胸血管麻醉学会急救与复苏分会. 中国急性心力衰竭急诊临床实践指南(2017)[J].中华急诊医学杂志,2017,26(12):1347-1357. [5] LYLE M A, BROZOVICH F V. HFpEF, a Disease of the vasculature: A closer look at the other half[J].Mayo Clin Proc,2018,93(9):1305-1314. [6] 常三帅,高颖,夏时俊,等. 中国心房颤动患者地高辛应用时限与不良预后的相关性研究[J].中华心血管病杂志,2020,48(9):728-734. [7] 汪雁博,郝国贞,姜云发,等. 左西孟旦对急性失代偿性心力衰竭患者右心功能的影响研究[J].中国全科医学,2019,22(27):3328-3332. [8] 刘燕飞,王剑,尹磊. 托伐普坦对急性充血性心力衰竭合并慢性肾功能不全患者的治疗效果[J].中国临床药理学杂志,2021,37(6):655-657. [9] 梅姜,曾勇. 左西孟旦在重症患者中应用效果的研究进展[J].实用心脑肺血管病杂志,2019,27(10):10-14. [10] 高瑞敏. 血清 H-FABP、Hcy水平与CHF患者心室重构及预后的关系[J].心血管康复医学杂志,2019,28(4):415-419. [11] CUNNINGHAM J W, VADUGANATHAN M, CLAGGETT B L, et al. Effects of sacubitril/valsartan on N-terminal pro-B-type natriuretic peptide in heart failure with preserved ejection fraction[J].JACC Heart Fail,2020,8(5):372-381. [12] DUBROCK H M, ABOUEZZEDDINE O F, REDFIELD M M. High-sensitivity C-reactive protein in heart failure with preserved ejection fraction[J].PLoS One,2018,13(8):36. [13] 孙科远,黄高忠,袁方,等. 缺氧诱导因子1α在慢性心力衰竭急性失代偿诊断及预后判断中的价值[J].上海交通大学学报(医学版),2018,38(4):426-429.
2023, Vol. 40 
