The present study aimed to investigate the effectiveness and safety of intravenous Cinepazide in the treatment of severe decompensated heart failure in patients who were unresponsive to traditional treatment with diuretics, angiotensin-converting enzyme inhibitors (ACEIs) and digitalis drugs. Patients with severe decompensated heart failure were recruited into this multicenter, randomized, controlled and parallel-group study and received treatment with either Cinepazide or Dobutamine therapy. In the Cinepazide group, a continuous infusion of Cinepazide was performed at 4 μg/kg·min for 23 h. In the control group, dobutamine was infused for 1 h at 2 μg/kg·min and then at 4 μg/kg·min for 23 h. The therapeutic effectiveness and safety were evaluated comprehensively. There were 120 patients in the Cinepazide group and 106 in the control group, all of whom received the evaluation of therapeutic effectiveness and safety. The effective rate was 31.9%(38/120) in the Cinepazide group and 17.9% (19/105) in the control group (P<0.01). After treatment for 24 h, the left ventricular ejection fraction (LVEF) was increased by 6.35% in the Cinepazide group and 4.6% in the control group (P>0.05). The mean stroke volume (SV) was increased by 11.1 ml in the Cinepazide group and 2.8 ml in the control group (P<0.05). The dyspnea and clinical manifestations were significantly improved in the Cinepazide group as compared to the control group. The plasma brain natriuretic peptide (BNP) level was significantly reduced after treatment with cinepazide (1997±865 pg/ml vs 384±114 pg/ml, P<0.005), and with dobutamine (1879±202 pg/ml vs 1025±48 pg/ml, P<0.005). Statistical analysis showed the significantly lower BNP level after treatment in the cinepazide group (P<0.005). No severe adverse effects were observed in either two groups. The incidence of adverse effects in the Cinepazide group was dramatically lower than in the control group (P <0.05). Adverse effects included hypokalemia, hypotension and premature ventricular contraction. When compared with Dobutamine, Cinepazide has definite effectiveness and higher safety in the treatment of severe decompensated heart failure, and all patients have favorable tolerance.