| Background In recent years, with the rapid development of society, cardiovascular disease incidence, which caused by obesity and lifestyle changes, increased year by year. The prevalence of heart failure increased rapidly with age-mortality rate of 4 years was 50%, as high as one year mortality rate of patients with severe heart failure, becoming an important public health problem worldwide threatened to human health. At present, the goal in heart failure treating is not only to alleviate the symptoms, improve the quality of life; but also to delay and prevent the deterioration of heart failure by the mechanism of ventricular remodeling, to improve prognosis and to reduce mortality as well as re-hospitalization rate. Through the inhibition of fatty acid oxidation and the increase of glucose metabolism, Trimetazidine can improve the utilization ratio of oxygen on the premise of not affecting the myocardial oxygen consumption and blood supply, which will do benefit to reduce ischemic symptoms and improve heart failure. This progression paper studies the effects of Trimetazidine on heart function, endothelial function and serum levels of related factors in patients with chronic heart failure.Objective The purpose of this study is to establish a reasonable, effective and safe treatment for patients with chronic heart failure, and to observe the effects of Trimetazidine on heart function, endothelial function and serum levels of related factors in those patients.Methods According to the inclusion criteria,70 patients of chronic heart failure were selected and randomly divided into two groups. The control group was gave conventional therapy (diuretics, angiotensin converting enzyme inhibitors and angiotensin receptor blockers and β-adrenoceptor blockers, aldosterone receptor antagonists). On the basis of the control group, the treatment group was in treatment of oral salt acid Trimetazidine piece. Before treatment,1 months after treatment and 3 months after it,the left ventricular ejection fraction (LVEF),left ventricular end diastolic volume (LVEDV) was detected by the ultrasonic Heartbeat chart; serum brain natriuretic peptide(BNP) was determined by analysis of enzyme immunoassay; they were gave 6-min walking test(6MWT); the level of serum nitric oxide was determined by nitrate reductase assay; the endothelin-1 (ET-1) was determined by Radio immunoassay; interleukin 6 (IL-6) and MMP-9 in serum were determined by enzyme linked immunosorbent assay, hs-CRP was determined by latex enhanced immune turbidimetric method; finally, results were statistically analyzed by SPSS19.0 statistical software.Result Compared with before treatment, left ventricular ejection fraction, serum nitric oxide and 6MWT experiment results after treatment of 1 month and 3 months in two groups had significant difference (P<0.05), which showed a trend of rise, and a significant difference was found in two groups (P<0.05); left ventricular end-diastolic volume, serum brain natriuretic peptide, vascular endothelin-1, C-reactive protein, interleukin 6 and serum MMP-9 after treatment of 1 month and 3 months in two groups had significant difference (P<0.05), which showed a trend of rise.Conclusion This study shows that Trimetazidine can improve the left ventricular and the content of serum nitric oxide of patients with chronic heart failure score, on the base of conventional drug evidence-based dose of treatment. Trimetazidine has an obvious effect in 6MWT experiment result of patients with chronic heart failure, which reduced the left ventricular end diastolic volume and serum brain natriuretic peptide of those patients. Trimetazidine can significantly improve the effect of treatment of heart failure by reducing endothelin-1, C- reactive protein, interleukin 6 and serum MMP-9 in patients with chronic heart failure as well. |
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