L-carnitine For Chronic Heart Failure In Acute Aggravating Period Of Efficacy Research Recently

Objective: Observation on the basis of conventional treatment combined with L-carnitine on different types of chronic heart failure in acute aggravating period of clinical curative effect,6-minutes walking distance experiment,LVEF,NT-proBNP.The influence of the average hospitalization days,At the same time,the incidence of adverse drug reactions included.Within 30 days of hospitalization rates again,and were followed for all-cause mortality and heart failure in the quality of life scores.Discusses optimization of the recent efficacy and safety of myocardial energy metabolic drugs.Methods: 243 patients were selected with cardiomyopathy,ischemic cardiomyopathy and hypertensive heart disease of three types of chronic heart failure with acute aggravating period,At the same time,satisfy the following conditions :(1)history of heart failure more than a month,and exists large dyspnea,edema,liver or lung's aggravating,chest X-ray prompting congestion and edema of the lungs worsening clinical manifestations such as heart failure;(2)the cardiac function NYHA class III or IV(as table 1);(3)LVEF(left ventricular ejection fraction)< 50%;(4)the NT-ProBNP > 400 pg/ml.The following cases have been left out in this study:(1)History of acute heart failure within 1 month;(2)Allergies of L-carnitine;(3)Have been blood disease,hemorrhagic disease,acute cerebral apoplexy,history of seizures,moderately severe anemia,severe thyroid function hyperfunction or drops,malignant tumor;(4)severe liver failure;(5)severe renal failure line of dialysis treatment.Those with severe heart valve disease,congenital heart disease.Patients were randomly divided into control group and treatment group,Control group give routine standardization of heart failure treatment,treatment group on the basis of add 2.0 g with l-carnitine static drops 2 times a day,application 7 days in a row.In front of the hospital to determine the clinical therapeutic effect,and the determination of 6 minutes walking distance,left ventricular ejection fraction,the plasma NT-ProBNP,serum creatinine,serum sodium levels and other indicators,calculated the average hospitalization days,at the same time observe the incidence of drug adverse reactions durin.Follow-up of 30 days after discharge,calculate the secend hospitalization rates,all-cause mortality of heart failure,the discharge of 30 days of Minnesota heart failure in the quality of life questionnaire scores.Results:1 There was no statistical difference between different subgroups according to the risk stratification and baseline data in gender,age,with atrial fibrillation,diabetes,serum creatinine,cardiac function classification,LVEF and LVDD,NT-Pro BNP basic treatment,blood potassium,sodium,and heart failure(beta blockers and ACEI/ARB,digoxin,spironolactone,diuretics)(P ? 0.05).2 Comparison beteen the two groups after treatment curative effect: clinical curative effect of treatment group efficiency,LVEF,were significantly higher than that of control group(P < 0.05),inefficient in the clinical curative effect of treatment group,serum creatinine,NT-ProBNP level,and the average hospitalization day significantly lower than that of control group(P < 0.05).Subgroup analysis showed that patients with high blood pressure,heart disease NT-ProBNP treatment group were significantly lower than the control group(P<0.05);Ischemic cardiomyopathy patients in treatment group the NT-ProBNP level,the average hospitalization day is lower than the control group(P<0.05),serum sodium level slightly higher than the control group(P < 0.05);The DCM patients serum creatinine levels only significantly lower than the control group(P<0.05).3 There was no no statistical significance between the two groups(P> 0.05)on mortality,treatment group readmission rate was significantly lower than the control group(7.4% VS 15.7%,P<0.05).Except death patients,treatment group is significantly higher than control group(P<0.05)about the quality of life questionnaire scores of Minnesota heart failure after 30 days.4 Comparison on safety: the treatment group was not high fever,seizures and serious adverse reactions such as allergic reactions;Treatment group of gastrointestinal symptoms,including(nausea,vomiting,abdominal distension)and there was no statistically significant difference in the control group(P> 0.05).Conclusion:1 l-carnitine,as a kind of optimization of myocardial energy metabolism drugs,can improve cardiac function significantly,reduce such confinement,improve the quality of the recent life,reduce hospitalization rates again in patients with acute aggravating period of chronic heart failure.2 L-carnitine was differences in curative effect beteen patients with different types of heart failure.High blood pressure,heart disease and ischemic cardiomyopathy patients benefit the most.3 Based on conventional treatment,L-carnitine combined was no serious adverse reactions.