RESUMEN
AIM: To explore the efficacy of torasemide combined with levocarnitine in the treatment of chronic heart failure (CHF). METHODS: From July 2018 to July 2020, 75 patients with CHF were recruited and randomly assigned into the control group (37 cases) and the study group (38 cases) according to the random number table method. The control and study groups were treated with levocarnitine and the combination of levocarnitine and torasemide, respectively. The clinical efficacy of the two groups was evaluated. The ventricular remodeling indexes and 6-minute walk test (6MWT) distance were compared between the two groups before and after treatment. The serum levels of serum galectin-3 (Gal-3), interleukin-33 (IL-33), hypersensitive C-reactive protein (hs-CRP), and the plasma concentrations of N terminal pro B type natriuretic peptide (NT-proBNP) and brain natriuretic peptide (BNP) were determined. RESULTS: (1) After treatment, the total clinical effective rate of the study group (92.11%) was higher than that of the control group (72.97%) (P<0.05). (2) The diastolic interventricular septal thickness (IVST) and diastolic left ventricular posterior wall thickness (LVPWT) were decreased following the treatment in both groups (P<0.05), whereas the treatment led to the increases of the left ventricular mass index (LVMI) and left ventricular ejection fraction (LVEF) in both groups (P<0.05). Compared with those in the control group, IVST and LVPWT in the study group were lower (P<0.05), and LVMI and LVEF were higher (P<0.05). (3) The levels of serum Gal-3, IL-33 and hs-CRP in the two groups were decreased after treatment (P<0.05); compared with those in the control group, the levels of serum Gal-3, IL-33 and hs-CRP were reduced to a greater extent in the study group (P<0.05). (4) Compared with that before treatment, 6MWT distance in both groups increased after treatment (P<0.05); the improvement in the study group was more significant relative to those in the control group (P<0.05). (5) Compared with before treatment, the expression levels of plasma NT-proBNP and BNP in the two groups were decreased after treatment (P<0.05); the reduction of plasma NT-proBNP and BNP levels in the study group was greater than the control group (P<0.05). CONCLUSION: Torasemide combined with levocarnitine is more effective than levocarnitine monotherapy in the treatment of CHF and can significantly improve ventricular remodeling index and motor function, reduce serum inflammation, and enhance cardiac function with definite curative effect.
RESUMEN
Left ventricular remodeling index (LVRI) was assessed in patients with hypertensive heart disease (HHD) and coronary artery disease (CAD) by real-time three-dimensional echocardi-ography (RT3DE).RT3DE data of 18 patients with HHD,20 patients with CAD and 22 normal con-trols (NC) were acquired.Left ventricular end-diastolic volume (EDV) and left ventricular end-diastolic epicardial volume (EDVepi) were detected by RT3DE and two-dimensional echocar-diography Simpson biplane method (2DE).LVRI (left ventricular mass/EDV) was calculated and compared.The results showed that LVRI measurements detected by RT3DE and 2DE showed sig-nificant differences inter-groups (P<0.01).There was no significant difference in NC group (P>0.05),but significant difference in HHD and CAD intra-group (P<0.05).There was good positive correla-tions between LVRI detected by RT3DE and 2DE in NC and HHD groups (r=0.69,P<0.01; r=0.68,P<0.01),but no significant correlation in CAD group (r=0.30,P>0.05).It was concluded that LVRI derived from RT3DE as a new index for evaluating left ventricular remodeling can provide more su-periority to LVRI derived from 2DE.