Effects Of Combined Treatment With Perindopril And Candesartan On Patients With Congestive Heart Failure

ObjectiveTo observe the effects of combined treatment with perindopril and candesartan on rats and patients with congestive heart failure (CHF) by animal experiment and clinical trial in order to provide a basis for the clinical medication.MethodsClinical trial:160CHF patients were randomly divided into four groups(n=40): control group, combined treatment group, candesartan group and perindopril group. Therapeutic schedule (16weeks):control group:digoxin0.36mg·d-1, combined treatment group:perindopril4mg·d-1and candesartan8mg·d-1, candesartan group: candesartan8mg·d-1and perindopril group:perindopril4mg·d-1. After the treatment, the improvement of cardiac function, r morphology of left ventricula[left ventricular end systolic diameter(LVESD), left ventricular posterior wall thickness(LVPWT), left ventricular end diastolic dimension(LVEDD), interventricular septum thickness (IVST)], the content of cytokines related to ventricular remodeling(including IL-6, MM P-3,-9and NT-pro-BNP) and safety pharmacology(including blood presure, heart rate, serum kalium, AST, ALT, Cr and rate of adverse reaction)] of patients in every groups were measured.ResultsClinical trial:effective rate of cardiac function improvement in group B(95%) were higher than that in the others group (80%,75%and60%) statistically(P<0.05). Compared to control group, the LVESD, LVEDD, IVST, LVPWT and content of IL-6,MMP-3,-9and NT-pro-BNP declinded and the LVEF elevated statistically (P<0.05) in the treatment groups, and these indicators in combined treatment group were differnt statistically with that in candesartan group and perindopril group. The difference of blood presure, heart rate, serum kalium, AST, ALT, Cr and rate of adverse reaction between control group and the others groups were not significant statistically(P>0.05).ConclusionBoth perindopril and candesartan could improve the cardiac function, restrain the progress of ventricular remodeling, and perindopril combined with candesartan is remakably superior to perindopril or candesartan alone in treating patients with CHF.