Efficacy and Safety Prediction of Milrinone or Levosimendan as Initial Inotropic Drug Therapy in Patients With Acute and Advanced Heart Failure With Renal Insufficiency

Inclusion Criteria:

• 18-80 years old
• Patients who were clearly diagnosed with heart failure ( cardiac insufficiency ) andLVEF(Left Ventricular Ejection Fraction) < 50 %, and were judged by the physician toneed and agree to use levosimendan or milrinone to maintain hemodynamic stability

Exclusion Criteria:

• chronic heart failure and New York Heart Association ( NYHA ) class I ~ II
• Complicated with infective endocarditis, aortic dissection, severe liver dysfunction (child-pugh C ), severe renal insufficiency ( CrCl < 30 ml / min ), hypertrophicobstructive cardiomyopathy, ventricular assist device or surgical cardiac surgerywithin 30 days before the use of levosimendan
• Patients with severe ventricular arrhythmia 1 within 24 hours before levosimendan andsystolic blood pressure 100 times / min within 2 hours before levosimendan
• During hospitalization, other positive inotropic drugs 2 were used when levosimendanwas intravenously pumped or dripped, excluding the use of catecholamines for rescue
• received positive inotropic drug 2 treatment in the last 30 days
• Lack of serum creatinine, brain natriuretic peptide or brain natriuretic peptideprecursor, serum total bilirubin, cardiac ultrasound baseline ( within 14 days beforeusing levosimendan ) data
• pregnant and lactating women