The Effects Of Ivarabrine Combined With Qiliqiangxin Capsule On The Heart Rate Variability And Cardiac Structure And Function In Chronic Heart Failure Patients With Mid-range Ejection Fraction

objective: To observe the effect of ivabridine combined with qiliqiangxin capsule on heart rate variability and cardiac structure and function in chronic heart failure(CHF)patients with mid-range ejection fraction.Methods: 120 cases of heart failure patients with median EF in CHF patients in our hospital were selected.Its randomized double-blind principle,all patients were divided into four groups,ivarabridin group,qiliqiangxin capsule group,combined treatment group and control group,in accordance with the guidelines for the treatment of heart failure combined with different drugs for treatment,observation before treatment and treatment 3 months after the patient NYHA grading improvement,statistics total effective rate;The mean heart rate,6MWT distance and 90 days readmission were observed.Patient LVEF was measured by echocardiography.Holter results at 3 months were recorded.Time domain index of heart rate variability was recorded.BNP,myocardial fibrosis indexes(Gal-3 and sST2)and immune indexes were detected in the four groups.The cases of dizziness,headache,flash,blurred vision,nausea and vomiting in the four groups were observed,and the adverse reaction rate was calculated.SPSS22.0 was used to analyze the data,the measurement data was expressed as((?)x±s),the comparison between groups was expressed as t test,the count data was expressed as n(%),the comparison between groups was tested as ?2,the rank sum test was used as grade data,and the difference was statistically significant(P < 0.05).Results:There were no significant differences in age,gender,cardiac function grade,smoking and drinking history,and disease complications among the four groups(P>0.05).There was no statistically significant difference in NYHA cardiac function score between the first four groups of patients treated with chronic heart failure(P>0.05).After treatment,all the four groups were reduced after 1 month,but the degree of reduction was not significant,there was no statistical difference(P>0.05),but at 2 months and 3 months were significantly lower than before treatment(P<0.05).Repeated measurement anova was performed for NYHA cardiac function score.After treatment,NYHA cardiac function score was significantly reduced in all the four groups(P<0.05),and the difference was more significant in the combined group(P<0.01).The 6MWT and 90-day readmission of each group were statistically improved compared with that before the experiment,but the improvement was not significant in the control group(P >0.05),and the improvement was significant in the other three groups(P<0.05).Comparison of patients in the four groups showed no significant difference after 1 month of treatment(P>0.05),and the difference was more significant after 2 months and 3 months of treatment(P<0.01).There was no significant difference in left ventricular ejection fraction between the four groups before the experiment(P>0.05).Left ventricular ejection fraction after treatment compared with the combined group was superior to the control group,the difference was statistically significant(P<0.05),but compared with ivabridin group and qiliqiangxin capsule group,the difference was not statistically significant(P >0.05).Heart rate and heart rate variation rate of the first four groups: heart rate and rMSSD,SDNN,SDANN levels compared,the difference was not statistically significant(P > 0.05),compared with the control group,ivabridin group,qiliqiangxin capsule group,the combined group after 3 months of treatment heart rate and rMSSD,SDNN,SDANN levels were higher(P < 0.05).There was no significant difference in BNP?TNF-??IL-33?Gal-3 and sST2 between the first four groups of patients with chronic heart failure.After treatment,BNP?TNF-??IL-33?Gal-3 and sST2 in all the three groups except the control group changed at 1 month after treatment,but at 2 months and 3 months after treatment,the changes were more significant than those before treatment(P<0.05),and the changes of BNP?TNF-??IL-33?Gal-3 and sST2 in the combined group were more significant(P<0.01).There was no significant difference inCD3+?CD4+?CD4+/CD8+ and NK between the first four groups of patients with chronic heart failure.After treatment,except for the control group,patients in the other three groups showed changes in CD3+?CD4+?CD4+/CD8+ and NK at the course of 1 month,but at 2 months and 3 months after treatment,the changes were more significant than those before treatment(P<0.05),and the changes in CD3+?CD4+?CD4+/CD8+ and NK were more significant in the combined group(P<0.01).There was no significant difference in the incidence of adverse reactions between the four groups(?2=0.444,P= 0.505).Conclusion: The conclusion is that ivabridin combined with qiliqiangxin capsule treatment can significantly enhance the efficacy,improve the heart rate of patients,treatment to improve the process of myocardial fibrosis has a significant effect,and the use of this program treatment safety is higher.In summary,CHF patients given ivabridin combined with qiliqiangxin capsule treatment can significantly enhance the curative effect,improve the patient heart rate and heart rate variability,significantly enhance the curative effect,and high safety,effectively improve the prognosis of patients.