The Clinical Research On Patients Of CHF Treated With Simvastatin And Trimetazidine

Objective:The research focused on the clinical efficacy and the effect on ventricular remodeling of simvastatin combined with trimetazidine in treatment of chronic heart failure (CHF).Methods:In September 2009 have been selected in our hospital in patients with chronic congestive heart failure 276,146 cases were male patients,130 cases were female patients, aged 48-77 years, mean 59.6 years old. The history of heart failure is from 4 months to 15 years, the average history of 5.2 years. Underlying cause of 132 cases of coronary heart disease,61 cases of rheumatic heart disease, hypertensive heart disease in 53 cases,30 cases of dilated cardiomyopathy. Criteria: levelⅡ-Ⅳheart function (NYHA), echocardiography and left ventricular ejection fraction (LVEF)<45%, history of congestive heart failure should be more than 4 months. Randomly divided into 4 groups, the conventional treatment group (A group) 69 cases,37 males and 32 females, aged 50 to 76 years; simvastatin treatment group (B) 69 patients,35 males and 34 females, Age 48 to 77 years; trimetazidine treated group (C group) 69 cases,36 males and 33 females, aged 49 to 76 years of age; simvastatin trimetazidine treated group (D group),69 cases 38 males and 31 females, aged 49 to 77 years old.Between the four groups of age, gender, underlying etiology, course, heart function classification, hypertension, diabetes, Dyslipidemia and LVEF of differences were not statistically (P>0.05). All general correction in patients with cardiac insufficiency and different drug treatment for primary disease according to the above-mentioned groups. Group A is given only General corrective cardiac dysfunction and drug treatment for primary disease; B group received simvastatin 20mg qn; C group received trimetazidine 20mg tid; D group received simvastatin 20mg qn+trimetazidine 20mg tid. Before treatment and 6 months after treatment, asked in detail about the disease and do physical examination, record cardiac function. Check the blood count, blood biochemistry. According to the degree of blood pressure and tolerability of the drug dose adjustments, and finally cardiac function measured by echocardiography and ventricular remodeling indicators. And clinical application of echocardiography:American-HP 8100 with ultrasound, the probe frequency of 215 MHz. Patients were left lateral position, according to echocardiographic left ventricular wall of 16 sub-stage method are shown with the apical four chamber view of apical left ventricular long axis view, left ventricular end systolic diameter, respectively, LVESD, left ventricular end diastolic diameter LVEDD, Room Interval and left ventricular posterior wall IVSD and LVPWD. According to De. veretLx corrected left ventricular mass index calculated LVMI (LVMI=left ventricular weight (LVmass)/ body surface area. left ventricular weight (LVmass=1.04 [(EDD+IVST+LVPWT) 3-EDD3]-13.6) and left ventricular injection Blood fraction EF. ultrasonography satisfied with the quality. observed four groups of heart failure control patients. selected when patients were selected and followed up for 6 months, venous blood from each of 10ml, using enzyme-linked immunosorbent assay in peripheral blood of matrix metalloproteinases -9 (MMPs-9) and high sensitivity C-reactive protein (high, sensitivity-Creactive protein, hs-CRP) levels.Results:Comparison of treatment evaluation before and after treatment in patients with cardiac function and cardiac morphological parameters, simvastatin trimetazidine treatment group than in the other 3 groups were significantly (P<O.05).Conclusion:The routine addition of anti-heart failure drugs simvastatin and trimetazidine treatment of chronic congestive heart failure can improve efficacy, improving left ventricular remodeling, cardiac function improved significantly.