Observation Of Short-Term Inflammatory Factors And Non-Invasive Hemodynamics In Patients With Chronic Heart Failure By Ivabradine Combined With Dapagliflozin

Objective:To observe the effect of ivabradine combined with dapagliflozin on short-term inflammatory factors and non-invasive hemodynamics in patients with chronic heart failure.Methods:Ninety patients with chronic heart failure(Chronic Heart Failure(CHF))admitted to our hospital from February 2019 to February 2021 were selected as study subjects,and they were divided into control and observation groups according to the random number table method,with 45 cases in each group.The control group was treated with dapagliflozin,and the observation group was treated with ivabradine in addition to this treatment.Serum inflammatory factor levels.including tumor necrosis factor-α(INF-α).interleukin-6(IL-6),Hypersensitive-C-Reactive-Protein(HCRP).and nuclear reactivity protein(CRP),were compared between the two groups.hs-CRP)and Nuclear Factor Kappa-B(NF-κB),and compared serum N-terminal pro-B-type Natriuretic Peptide(NT-proBNP)and growth-stimulated expression gene 2 protein(NT-proBNP)in the two groups after treatment.The levels of N-terminal pro-B-type Natriuretic Peptide(NT-proBNP)and Suppression of Tumorigenicity 2(ST2)were used to compare the post-treatment cardiac function parameters,including Left Ventricular End Systolic Diameter(LVESD),heart rate,cystatin C,Left Ventricular Ejection Fraction(LVEF),and heart rate.The levels of brain natriuretic peptide(BNP)were compared between the two groups after treatment.In addition,we compared the post-treatment ventricular remodeling indexes,including Left Ventricular Shortening(LVFS),Left Ventricular Posterior Wall Thickness(LVPWT),and Left Ventricular Weight Index(LVWI).Myocardial Weight Index(LVMI).and end-systolic septal thickness(Instituto Venezolano de los Seguros Sociales(IVSS))to compare the post-treatment myocardial fibrosis levels in the two groups,which included laminin(Laminin,LN),and connective tissue growth.Laminin(LN),Connective Tissue Growth Factor(CTGF),Hyaluronic Acid(HA),and non-invasive hemodynamic parameters including Pulmonary Capillary Wedge Pressure(PCWP),Cardiac Index(CI),Systemic Vascular Resistance(SVR),and Right Atrial Pressure(RAP),were compared between the two groups,and the incidence of adverse events and readmission rates were compared between the two groups,as well as The incidence of adverse events and readmission rates after treatment were compared between the two groups.Results:(1)There were no statistically significant differences between the two groups in terms of general baseline data such as gender,age,BMI,education,usual residence,marital status,history of hypertension,history of tea drinking,history of hyperlipidemia,history of smoking,history of diabetes,history of alcohol consumption,history of chronic bronchitis,cardiac function classification and LVEF stratification(P>0.05);(2)After treatment,patients in the observation group had a higher incidence of TNF-α,IL-6,hs-CRP and NF-κB levels were significantly lower in the observation group than in the control group(P<0.05);(3)NT-proBNP and ST2 levels were significantly lower in the observation group than in the control group after treatment(P<0.05);(4)LVESD,heart rate,LVEF and LVEDD indexes were better in the observation group than in the control group after treatment(P<0.05);(5)After treatment,the BNP level of patients in the observation group was significantly lower than that of the control group(P<0.05);(6)After treatment,the LVFS,LVPWT,LVMI and IVSS indexes of patients in the observation group were better than those of the control group(P<0.05);(7)After treatment,the LN,CTGF and HA levels of patients in the observation group were lower than those of the control group(P<0.05);(8)After treatment,the(8)After treatment,the PCWP,CI,SVR and RAP in the observation group were better than those in the control group(P<0.05);(9)After treatment,the overall incidence of adverse events and readmission rates in the observation group were(2.22%)and(2.22%)significantly lower than those in the control group(15.56%)and(13.33%),respectively(P<0.05).Conclusion:The treatment of CHF patients with ivabradine combined with dapagliflozin can effectively reduce their inflammatory factor response,regulate serum NT-proBNP and ST2 levels,improve patients’ cardiac function,lower BNP levels,reduce the progression of ventricular remodeling.alleviate the process of myocardial fibrosis,reduce patients’ myocardial damage,improve hemodynamics,reduce adverse effects and readmission rates,and effectively improve the therapeutic effect.