Zhao Meiling, Hou Yunfeng, Yuan Meng, Ma Shuang, Yue Yifeng
Department of Critical Care Medicine, Zibo Central Hospital, Zibo, 255000, China.
Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University, JiNan, 250014, China.
J Cardiothorac Surg. 2025 Jan 7;20(1):43. doi: 10.1186/s13019-024-03316-3.
To investigate the therapeutic effect of levosimendan on hemodynamics in patients undergoing major cardiac surgery and presenting with acute postoperative heart failure.
The subjects of the study were 160 patients with severe cardiac conditions who underwent surgery and had acute heart failure. Eighty cases each were assigned to the research and control groups using a random number table. Document the general patient data for each of the two groups; compare the clinical outcomes of the two groups. The hemodynamic states of the two groups were compared both before and after therapy. 48 h after surgery, echocardiography was performed in both groups to determine cardiac function. 48 h after surgery, N-terminal pro-brain B-type natriuretic peptide (NT-Pro-BNP) levels were compared between the two groups.
The overall effective rate was significantly higher in the research group (92.5%) compared to the control group (76.25%, P < 0.05). Post-treatment, the research group demonstrated a significant reduction in CVP (9.25 ± 2.11 cmH2O vs. 11.36 ± 3.08 cmH2O, P < 0.001), heart rate (100.30 ± 8.69 bpm vs. 105.74 ± 7.69 bpm, P < 0.001), and lactic acid levels (1.68 ± 0.59 mmol/L vs. 2.69 ± 0.55 mmol/L, P < 0.001). The research group also showed improvements in SBP (117.23 ± 8.74 mmHg vs. 113.25 ± 7.55 mmHg, P = 0.002) and urine output (4.21 ± 1.76 mL/kg/h vs. 3.65 ± 1.23 mL/kg/h, P = 0.021). Cardiac function indicators 48 h after surgery indicated a higher LVEF (55.21 ± 8.04% vs. 47.18 ± 6.60%, P < 0.001) and lower LVEDVi and LVESVi in the research group (P < 0.001 for both). NT-Pro-BNP levels were significantly lower in the research group (6010.19 ± 1208.52 pg/mL vs. 9663.21 ± 2391.34 pg/mL, P < 0.001). The incidence of complications was lower in the research group (5% vs. 22.5%, P = 0.001).
Cardiac surgery patients are prone to complications with acute heart failure after surgery. Treatment with levosimendan can significantly improve clinical efficacy and reduce complications. It can also effectively improve patients' cardiac function and promote hemodynamic stability.
探讨左西孟旦对接受心脏大手术并出现术后急性心力衰竭患者血流动力学的治疗效果。
研究对象为160例接受手术且患有急性心力衰竭的重症心脏病患者。使用随机数字表将80例患者分为研究组和对照组。记录两组患者的一般资料；比较两组的临床结局。比较两组治疗前后的血流动力学状态。术后48小时，两组均进行超声心动图检查以确定心功能。术后48小时，比较两组N末端脑钠肽前体（NT-Pro-BNP）水平。
研究组的总有效率（92.5%）显著高于对照组（76.25%，P＜0.05）。治疗后，研究组中心静脉压（CVP）显著降低（9.25±2.11cmH₂O vs. 11.36±3.08cmH₂O，P＜0.001）、心率（100.30±8.69次/分钟 vs. 105.74±7.69次/分钟，P＜0.001）和乳酸水平（1.68±0.59mmol/L vs. 2.69±0.55mmol/L，P＜0.001）。研究组的收缩压（SBP）（117.23±8.74mmHg vs. 113.25±7.55mmHg，P = 0.002）和尿量（4.21±1.76mL/kg/h vs. 3.65±1.23mL/kg/h，P = 0.021）也有所改善。术后48小时的心功能指标显示，研究组的左室射血分数（LVEF）更高（55.21±8.04% vs. 47.18±6.60%，P＜0.001），左室舒张末期容积指数（LVEDVi）和左室收缩末期容积指数（LVESVi）更低（两者均P＜0.001）。研究组的NT-Pro-BNP水平显著更低（6010.19±1208.52pg/mL vs. 9663.21±2391.34pg/mL，P＜0.001）。研究组的并发症发生率更低（5% vs. 22.5%，P = 0.001）。
心脏手术患者术后易发生急性心力衰竭并发症。左西孟旦治疗可显著提高临床疗效并减少并发症。它还能有效改善患者的心功能并促进血流动力学稳定。
