Abstract: 【Abstract】 Objective To summarize our experience in the treatment of acute myocardial infarction (AMI) patients complicated with acute heart failure using continuous renal replacement therapy (CRRT). Method We retrospectively analyzed 181 AMI patients treated in our ward. Eighty-eight of these patients were attacked with acute heart failure after patent blood flow of culprit vessels by primary PTC, and then treated with medications. CRRT was initiated in 50 patients because of the persistence of heart failure. Patient’s vital signs and tolerance to CRRT were closely monitored. Blood gas, electrolytes, plasma B-type natriuretic peptide (BNP) and C-reactive protein (CRP) were measured before and after CRRT. Left ventricle ejection fraction (LVEF) was measured. Patients were followed up for one year. Data were analyzed with SPSS13.0 software. Results CRRT was terminated in 2 patients due to thrombocytopenia, and in one patient due to insufficient perfusion of vital organs. Vital signs and heart failure symptoms improved in 47 patients. After CRRT, electrolytes improved, BNP and CRP decreased (P＜0.05), LVEF increased (P＜0.05), and BNP in ultrafiltrate became very low (P＜0.05). Three cases died of sudden cardiac death. Fortyfour patients discharged after 20～59 days, and they were followed up for one year. No deterioration of heart dysfunction was found, and no long-term hemodialysis was required. Conclusions CRRT is a relatively safe and effective strategy for patients with acute heart failure after AMI. It can decrease serum BNP and CRP remarkably, and improve heart failure symptoms and LVEF. It also helps the patients survive the dangerous period. Our patients treated with CRRT experienced a gradual improvement of cardiac function, and discharged from the hospital in a stable condition without heart failure recurrence and long-term dialysis during the follow-up period.

Key words: Acute myocardial infarction, Acute heart failure, Continuous renal replacement therapy (CRRT), B-type natriuretic peptide, C-reactive protein, Left ventricle ejection fraction