The Impact Of Shensongyanxin Caspule Combined With Atorvastation On QT Diapersion And Heart Rate Variability In Patients With Chronic Heart Failure

Objective:To observe the effects of shensongyangxin capsule in combination with atorvastatin on chronic heart failure (Chronic heart failure, CHF) patients with QT dispersion and heart rate variability,and to explore its mechanism.Method::A total of 120 patients with CHF who were hospitalized at Yanbian University Hospital from December 2013 to December 2014 were selected to receive routine CHF treatment (ACEI/ARB,β-receptor blocker, aldosterone receptor antagonists, etc.). They were randomized into four groups:Group A to D (each n= 30). Based on the above treatment, Group A was on the routine CHF treatment alone, Group B was fundamental anti heart failure treatment plus oral administration ofShensongYangxin Capsules (1.6 g/day, q.d.), Group C was on the routine CHF treatment plus oral administration of atorvastatin (20mg/night, q.d.), and Group D was on the routine CHF treatment plus oral administration of ShensongYangxin Capsules (1.6 g/day, q.d.) plus atorvastatin (20 mg/night, q.d.). The course of treatment was three months for each group. Before and after treatment, blood routine test, biochemical examination, NT-proBNP, ECG,24 h dynamic ECG and UCG were performed and their findings were recorded. Changes in QT dispersion and heart rate variability were compared among four groups before and after treatment.Result:1.Comparison of general information across four groups:No significant difference in age, gender, underlying heart disease and cardiac functional grading was noted among four groups (P>0.05).2.Comparisons of pre-and post-treatment QTd and QTcd across four groups:After treatment, both QTd and QTcdacross four groups shortened compared with those before treatment, with a statistically significant difference (P<0.05). Post-treatment intergroup comparison:QTd and QTcd markedly reduced in Group D as compared with Groups A, B and C (P<0.05), Compared with Group A and either Group B or C, no significant difference was noted (P<0.05). The results showed that the combination of the two drugs in the treatment of QTd and QTcd was better.3.Comparisons of all pre-and post-treatment parameters of HRV across four groups: SDNN, SDANN, SDNNI, RMSSD, LF and HF across four groups increased after treatment. Compared with those before treatment, for Group A there were statistical differences in increments in SDANN, SDNNI and LF (P<0.05); for Group B, SDANN, RMSSD, LF and HF changed markedly compared with those before treatment, with a statistically significant difference (P<0.05); for Group C, SDNN, SDANN, SDNN, RMSSD and LF elevated markedly after treatment (P<0.05);for Group D, all parameters of HRV changed markedly compared with those before treatment, with a statistically significant difference (P<0.05). Comparison of post-treatment improvement across groups:Improvements of SDNN, SDANN, RMSSD, SDNNI, LF and HF in Group D were superior to those in the other three groups (P<0.05); there were significant differences between Group A and either Group B or C (P<0.05). The results showed that the combination of the two drugs in the treatment of HRV was better.4.Comparison of pre- and post-treatment NT-proBNP values across four groups: Post-treatment NT-roBNP values reduced compared with pretreatment ones across groups, with a statistically significant difference (P<0.05). Comparison of post-treatment improvement across groups:post-treatment NT-proBNPvalues reduced more markedly in Group D compared the other three groups, with a statistically significant difference (P<0.05); there were significant differences between Group A and either Group B or C (P<0.05). The results showed that the combination of the two drugs in the treatment of NT-proBNP was better.5.Comparisons of pre- and post-treatment LVEF and LVEDD across four groups: After treatment, LVEDD reduced and LVEF elevated compared with those before treatment across four groups, with a statistically significant difference (P<0.05). Comparison of post-treatment improvement across groups:LVEDD and LVEF improved significantly in Group D compared with Groups A, B and C, with a statistically significant difference (P<0.05). The combined two kinds of drugs on LVEDD and LVEF improved better.Conclusion:Shensongyangxin capsule combined with atorvastatin can make the QT dispersion shortened and heart rate variability increased in patients with chronic heart failure, which improved the autonomic nerve function is its possible mechanism.