Effects Of Metoprolol And Shensongyangxin Capsule On P Wave Dispersion And High Sensitivity C-reactive Protein In Patients With Paroxysmal Atrial Fibrillation

Purpose:Explore metoprolol combined with Shensongyangxin capsule on patients with paroxysmal atrial fibrillation P wave dispersion (Pd) and high sensitivity Creactive protein (hs-CRP). Method:67patients with PAF were divided into3groups randomly, group A(metoprololgroup), group B(Shen-songyangxin capsule group) and group C(both drugs group), and62patients of sinus rhythm were chosen as control group. The Maximum P wave duration(P-max), Pd, plasma hs-CRP level, left atrial diameter(LAD) and the PAF recurrence rate were compared with the control group before and after the3-month-treatment. Result:(1) There are no significant differences in gender composition, NYHA cardiac function classification, LVEF, LVEDD between PAF group and SR group (P>0.05); Pd, hs-CRP were significantly higher in PAF group than those in SR group (P<0.05), but there is no significant difference in LAD between PAF group and SR group(P>0.05);(2) Before treatment, there are no significant differences in Pd, hs-CRP and LAD among A, B, C subgroup (P>0.05), metoprolol treatment significantly decreased Pd levels(P<0.05), but has no effect on hs-CRP levels (P>0.05); shensongyangxin capsule treatment significantly decreased Pd and Pmax(P<0.05); metoprolol combined with Shensongyangxin capsule significantly decreased hs-CRP levels (P<0.05); after treatment, there is no significant difference in LAD among three subgroups (P>0.05);(3) atrial fibrillation recurrence rate is lower in PAF group with Pd<40ms than those in PAF group with Pd>40ms (P<0.05), after3months treatment, the AF recurrence rates were signicicantly reduced in three subgroups (P<0.05), the AF recurrence rate is significantly lower in group C than those in group A and B (P<0.01);(4) When Pmax≥110ms, the sensitivity was91.04%, and the specificity was69.35%, the positive predictive value was76.25%, and The negative predictive value was87.76%; when Pd≥40ms, the sensitivity is86.57%, the specificity was90.32%, the positive predictive value was90.63%, the negative predictive value was86.15%; when the Pmax≥110ms and Pd≥40ms, the sensitivity was82.21%and the specificity was93.54%, the positive predictive value was93.22%, the negative predictive value was82.86%. Conclusion:1Inflammation is involved in the occurrence of PAF.2Metoprolol combined with Shensongyangxin capsule can effectively reduce the recurrence of paroxysmal atrial fibrillation.3Improvement of atrial remodeling and inflammation may be one of the pharmacological action of Shensongyangxin capsule4. Pmax combined with Pd is a predictive value of PAF recurrence.