The clinical curative effect of levosimendan on ischemic cardiomyopathy and the clinical significance for invasive monitoring of blood pressure

Abstract

Objective To explore the clinical curative effect of levosimendan on ischemic cardiomyopathy (ICM), to evaluate the feasibility and effect of the invasive monitoring of blood pressure (IBP)in treating ICM with levosimendan, and to provide clinical basis for the treatment of ICM. Methods 148 hospitalized patients with ICM from February 2015 to March 2016 were enrolled in this research.Levosimendan was pumped into their veins, and IBP was monitored for 24 hours directly and continuously by a radial artery puncture and catheter-indwell.At the same time, non-invasive blood pressure (NBP)was timingly monitored.Clinical curative effect and the ventricular systolic and diastolic function improvement before and after treatment were observed.The fluctuations of blood pressure level during the invasive and non-invasive monitoring of blood pressure were recorded. Results Overall efficiency of the therapy for 148 patients is 93.9% (139/148 cases). Echocardiography index was improved.Before treatment, left atrium inner diameter was (46.7 ± 4.7)mm, left ventricle inner diameter was (69.6±10.2)mm, pulmonary artery pressure (PAP)was (46.8±14.4)mmHg (1 mmHg = 0.133 kPa), and left ventricle ejection fraction (LVEF)(32.5 ± 8.3 %). While, after treatment, left atrium inner diameter was (41.5 ± 3.6)mm, left ventricle inner diameter was (63.5 ± 9.8)mm, PAP was (44.1 ± 13.2)mmHg, LVEF was (37.1 ± 8.1)%, all of which were obviously improved (each P 0.05). Systolic and diastolic blood pressure fluctuations during 24 hours were less in invasive monitoring than in noninvasive monitoring of blood pressure. Conclusions The clinical curative effect of levosimendan on ischemic cardiomyopathy is obvious, it can significantly improve cardiac function with slight adverse reactions.It is worth noticing that we should recommend the clinical utility of levosimendan.Invasive blood pressure monitoring can reflect more intuitively and accurately the blood pressure when using levosimendan in the treatment of ischemic cardiomyopathy.Therefore, it provides reliable basis to predict disease progression. Key words: Cardiomyopathies; Cardiotonic agents; Blood pressure