Effect Of Perindopril On The Cardiac Function And Prognosis Of The Patients With Heart Failure And Low-normal Blood Pressure

Objective:Heart failure is the end stage of various kinds of cardiovascular diseases,of which the diagnosis and treatment is a significant topic in 21 st century.According to the epidemiological study,15%~25% of the patients with heart failure were combined with low SBP,who usually had poor prognosis.In recent years,ACEI were recommended as the cornerstone of heart failure treatment by different heart failure guides.As is proved by research,ischemic heart disease was a major cause of heart failure;the relationship btween its cardiovascular events and blood pressure accorded to the "J curve".Therefore,with regard to the patients with heart failure and low-normal blood pressure,ACEI's further effect on blood pressure and prognosis deserved special attention,but the relevant research and report were rare at home and abroad.The purpose of the study was to observe the effect of perindopril on the cardiac function and short-term prognosis of the patients with heart failure and low-normal blood pressure.Metheds:142 hospitalized patients with chronic heart failure were enrolled from Dec.2015 to Dec.2016,including 71 males and 77 females,90 mmHg <SBP? 110 mmHg,NYHA ?~?,LVEF?45%,and randomly assigned to perindopril group(n=77)and conventional therapy group(n=65);both groups were given conventional therapy,and the experiment group were extraly given perindopril 2mg QD.Two weeks later,the dose of perindopril was raised to 4mg QD if no adverse reaction occurred.If the adverse drug reaction like cough and hypotension happened,the dose of perindopril was reduced to 2mg QD,and the drug should be suspended if necessary.During the three-month follow-up period,the NT-Pro BNP,LVEF,NYHA and MACE were recorded,and the rehospitalization rate of two groups were calculated respectively.Results:1 The difference of baseline data between two groups had no statistical significance(P>0.05),so the patients in two groups were comparable.2 The NT-Pro BNP level of two groups were both remarkably ruduced,which indicated an improvement of cardiac function,but the difference of NT-Pro BNP before and after treatment between two groups had no statistical significance(F=0.154,P=0.696).3 The LVEF of two groups were both improved,which indicated an improvement of cardiac function,but the difference of LVEF before and after treatment between two groups had no statistical significance(F=0.835,P=0.362).4 The NYHA of the perindopril group were observably improved,which indicated an improvement of cardiac function,and the difference had statistical significance,compared with the conventional therapy group(Z=-1.363,P=0.037).5 The difference of one-month rehospitalization rate between two groups had no statistical significance(X~2=1.225,P=0.268).However,the three-month rehospitalization rate of the perindopril group was 3.9%,which is much lower than that of conventional therapy group,and the difference between two groups had statistical significance(X~2=4.510,P=0.034),indicating that perindopril can effectively reduce three-month rehospitalization rate and improve short-term prognosis ultimately.6 There was no loss to follow-up among 142 patients.During the follow-up,2 cases of AMI,3 cases of rehospitalization,5 cases of coughing and 1 cases of hypotension occurred in perindopril group,9 cases of rehospitalization and 2 cases of AMI occurred in conventional therapy group.Conclusions:With regard to the patients with heart failure and lownormal blood pressure,perindopril can effectively reduce the rehospitalization rate,improving the cardiac function and short-term prognosis,not increasing the rate cardiovascular events.