Effect Of YangXinShi On Exercise Tolerance In Patients With Chronic Heart Failure

Objective: To observe the effect of yangxinshi on quality of life,cardiac function and exercise tolerance in patients with chronic heart failure.Methods: A prospective,randomized and controlled clinical study was conducted(Clinical trial Registration number:NCT03333499)Eighty consecutive patients with acute decompensated heart failure who were admitted to hospital from October 2017 to May 2018 were randomly divided into control group(n=30),yangxinshi group(n=30),trimetazidine group(n=10)and yangxinshi + trimetazidine group(n=10)after the condition stabilizes.The observation period was 6 months.All patients were surveyed by cardiopulmonary exercise test,ultrasonic cardiogram,EQ5 D and KCCQ score in baseline and 6 months after treatment.Results: In baseline,there was no significant difference in each observation index between the four groups.There was no significant difference in the parameters of exercise test and Ultrasonic Cardiogram EQ-5D and KCCQ score before and after treatment in the control group(P(29)0.05).The cardiopulmonary exercise test(anaerobic threshold,maximal oxygen uptake,exercise time,metabolic equivalent),ultrasonic cardiogram(left ventricular short axis shortening rate,left ventricular ejection fraction,cardiac output),EQ-5D and KCCQ score in yangxinshi group,trimetazidine group and yangxinshi+ trimetazidine group were significantly higher than those in baseline and control group at the same time.ultrasonic cardiogram(left ventricular end-diastolic volume,left ventricular end-systolic volume)was significantly lower than those before treatment and control group at the same time(P<0.05).The cardiopulmonary exercise test(maximum systolic blood pressure,maximum heart rate and heart rate heart rate variability)in yangxinshi group and yangxinshi group+trimetazidine group were significantly lower than those before treatment and control group at the same time(P(27)0.05),while there was no significant difference between the trimetazidine group and before treatment and the control group at the same time(P(29)0.05).There were no significant differences in cardiopulmonary exercise test,echocardiographic,EQ-5D and KCCQ scores between yangxinshi group and yangxinshi +trimetazidine group(P(29)0.05).There were no significant changes in resting systolic pressure,diastolic pressure,pulse pressure difference and resting heart rate between the four groups(P(29)0.05).Conclusion: Yangxinshi can significantly improve the systolic function,reverse myocardial remodeling and improve exercise tolerance and quality of life in patients with chronic heart failure on the basis of optimizing drug treatment.Its effect is similar to that of trimetazidine.The combination of the two drugs has no additional benefit than any single drug.Yangxinshi has no significant effect on resting blood pressure and heart rate,and can reduce the maximum systolic blood pressure,heart rate and heart rate change rate during exercise,making patients with chronic heart failure more easily tolerate exercise state,But trimetazidine had no such effect.