| Chronic heart failure(CHF) is the terminal stage of the development of cardiovascular disease, disability and mortality of cardiovascular diseases ranked the first. With the improvement of people’s living standards and healthcare, CHF patients increase every year, especially in the elderly people. CHF is the leading cause of death for our residents. Therefore, the new tools to assess the condition and treatment have become an important issue in cardiovascular research. At present, a series of studies at home and abroad have showed:(A) Myocardial energy metabolism plays an important role in the occurrence and development of heart failure. Metabolic therapy has gradually attracted people’s attention in patients with CHF. This paper focuses on the treatment effect of myocardial energy metabolism substance L-carnitine in patients with CHF.(B) A range of complex neurohormonal changes can be caused when people had heart failure. Many factors involved in humoral regulation of the cardiovascular system, besides enhanced sympathetic nerve excitability and activated renin-angiotensin-aldosterone system, which played an important role in myocardial and vascular remodeling. Humoral factor Copeptin was studied, and combined with the N-terminal pro-B-type natriuretic peptide precursor(NT-proBNP), thereby to investigate the assessment value of it in patients with CHF.According to the standards,145 cases of chronic heart failure(CHF) patients in the hospital were selected in this study. They were divided randomly into two groups: control group and L-carnitine group. The control group with 70 cases were dosed with routine western medicine, ingcluding angiotensin-converting enzyme inhibitors(ACEI) or angiotensin Ⅱ receptor blocker(ARB), β-blockers, digitalis therapy, and the L-carnitine treating group with 75 cases were dosed with L-carnitine given through Intravenous for 3g/d during 14 d on the basic treatment of routine western medicine. At The first day and the 14 th day of admission, to detect the L-carnitine group and the control group of New York Heart Association(NYHA) functional class; chocardiography indicators: before and after treatment changes of left atrial diameter(LAD), left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD); and before and after treatment changes of 6 minutes walk test, Results: After 14 d treatment, LVEF and LVEED in the two groups were improved, the difference was statistically significant(P<0.05), and the L-carnitine group was better than the control group, the difference was statistically significant(P<0.05). Before and after treatment, LAD of the two grounps was not statistically significant(P> 0.05). There were obvious improvments in 6 Minute walking test of the two groups after treatment(P<0.05), and the L-carnitine group was improved better than the control group(P<0.05). Conclusion: L-carnitine could improve cardiac failure cell energy metabolism in patients with CHF, and improve significantly cardiac function. The study provided better theoretical basis for the treatment of cardiac energy metabolism in patients with CHF.The concentrations of Copeptin and NT-proBNP were measured and compared before and after treatment in the first day and 14 th day. The results showed concentrations of Copeptin and NT-proBNP were significantly lower than before treatment(P <0.05), and the L-carnitine group was better than the control group(P <0.05); According to NYHA classification, 145 cases of chronic heart failure patients were divided into cardiac function III+IV group and cardiac function I+II group. Analyze the differences of the concentration of copeptin and NT-proBNP between two cardiac function groups; The results show: the concentrations of NT-proBNP and copeptin in the cardiac function III+IV group were significantly higher than that in cardiac function I+II group; The difference was statistically significant(P<0.05). By the pearson correlation analysis, the correlation of Copeptin and NT-proBNP of the patients with chronic heart failure was analyzed. The analysis showed that the concentration of Copeptin had positive correlation with NT-proBNP, and the correlation coefficients were 0.610,(P<0.05). All patients were followed-up for 12 months and divided into 2 groups, Cardiac event group, which included patients with cardiac death and readmission for worsening heart failure, and No cardiac event group. The relationship between the levels of copeptin and NT-proBNP and the cardiac events was analyzed. Conclusion: Plasma Copeptin has good value for clinical risk stratification and prognosis of patients with CHF, combined the concentration of plasma Copeptin and NT-ProBNP can improve the objectivity and truth of the patients. |
PDF Full Text Request