Objective  To explore the effects of recombinant human brain natriuretic peptide combined with levosimendan on cardiac function, myocardial fibrosis and safety in patients with acute heart failure (AHF).

Methods  90 patients with AHF admitted to Changzhou First People's Hospital from May 2021 to April 2023 were randomly divided into the intervention group and the control group. The intervention group was treated with recombinant human brain natriuretic peptide combined with levosimendan, and the control group was treated with levosimendan. Both groups were treated for 14 days. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and heart rate (HR) were recorded before and after treatment, and mean arterial pressure (MAP) was calculated. The levels of cardiac troponin T (cTnT) and myocardial creatine kinase isoenzyme (CK-MB) were measured in both groups. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) inflammatory factors were detected in both groups to assess the inflammation of the two groups. Serum soluble human stromal lysin (sST2) and serum fibroblast growth factor-21 (FGF-21) levels were detected in both groups to evaluate myocardial fibrosis levels. The incidence of adverse reactions in the two groups was observed to evaluate drug safety.

Result  A total of 90 AHF patients were included, with 45 cases in the intervention group and 45 cases in the control group. After 14 days of treatment, HR, CK-MB, IL-6, TNF-α, hs-CRP, sST2 and FGF-21 levels of the intervention group were lower than those of control group (P<0.05), LVEF, cTnT and MAP were higher than those in control group (P<0.05), and LVEDD level had no statistical difference (P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusions  Recombinant human brain natriuretic peptide combined with levosimendan can effectively improve cardiac function and myocardial fibrosis in patients with AHF with good safety.

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