Abstract: Abstract: Objective To report our experience with levosimendan in refractory heart failure caused by left ventricular noncompaction. Methods A total of 122 patients with refractory heart failure were collected in the cardiac intensive care unit of Tianjin Chest Hospital from January 2016 to December 2017. According to the causes of heart failure, the patients were divided into three groups including left ventricular noncompaction group (LVNC, n=6), ischemic cardiomyopathy group (ICM, n=91) and dilated cardiomyopathy group (DCM, n=25). All patient received continuous infusion of levosimendan for 24 hours on the basis of the failure of conventional treatment. The biological and echocardiographic data before and after 48 hours of levosimendan administration were analyzed and compared between three groups. Results Compared with data before administration, there were no significant improvement in the left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP) and N-terminal pro-brain natriuretic peptide (NTproBNP) after 48 hours of levosimendan infusion in LVNC group (P＞0.05). The LVEDD, LVEF, PASP and NTproBNP were all improved in ICM group (P＜0.01). And LVEF and NTproBNP were improved in DCM group (P＜0.01). After 48 hours of levosimendan administration, the improvement of LVEDD, LVEF, NTproBNP and PASP was more significant in ICM group than that in LVNC group (P＜0.05), and the improvement of LVEF and NTproBNP was more significant in DCM group than that in LVNC group (P＜0.05). Conclusion Levosimendan has poor efficacy in refractory heart failure caused by left ventricular noncompaction, and it may not be suitable for this type of patients.

Key words: cardiomyopathies, myocardial ischemia, cardiomyopathy, dilated, levosimendan, isolated noncompaction of the ventricular myocardium