Résumé
Objective To observe the efficacy and safety of trimetazidine/coenzyme Q10 combination in the treatment of the elderly patients with chronic heart failure(CHF).Methods Sixty-two male patients aged over 80 years with CHF were randomly divided into intervention group and control group.Patients in control group received optimal conventional CHF therapy according to the guideline for CHF,while patients in intervention group received trimetazidine of 20 mg,3 times per day,coenzyme Q10 20 mg,3 times per day,additionally for 6 weeks.Left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),plasma brain natriuretic peptide (BNP),6 min walking distance (6MWT) and NYHA cardiac function classification of two groups before and after treatment were observed.Results Before treatmen,the NYHA function class of patients in intervention and control groups were 2.8±0.7,2.7±0.7 respectively,after treatment were 2.1± 0.6,2.4 ± 0.7 respectively,the differences were significant before and after treatment (t=6.808,2.249;P＜0.01,P＜0.05).Before treatment,BNP of intervention and control groups were (540±351)ng/L,(483 ± 351) ng/L respectively,after treatment were (219± 172) ng/L,(316 ± 202) ng/L respectively,the differences were significant before and after treatment (Z =-4.927,-4.042;P ＜ 0.01).Moreover,after treatment,NYHA function class and plasma BNP in intervention group were significantly better than those in control group (t =-2.109,P ＜ 0.05;Z =-2.219,P ＜ 0.05).Before treatment,LVEF,LVEDD and 6MWT of intervention group were (44.3 ± 3.1) ％,(54.0 ± 4.7) mm and (217.0 ± 60.9) m respectively,after treatment were (46.8±3.9) ％,(53.2±4.3) mm and (267.0±91.1) m respectively,the differences were significant before and after treatment(t=-8.313,2.254,-4.561;P＜0.01 or P＜0.05).Moreover,after treatment,LVEF and 6MWT in intervention group were significantly better than those in control group ((44.9± 3.5)％,(213.2 ±78.1) m;t =2.000,2.186;P ＜ 0.05).No significant adverse events were detected in the intervention group.Conclusion Combination of trimetazidine and coenzyme Q10 on the basis of the conventional treatment in the elderly with CHF,can further improve cardiac dysfunction and have a good safety.
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Objective: To study therapeutic effects of simvastatin on vascular endothelial cell dysfunction in patients with coronary heart disease (CHD). Methods: According to LDL-C level, a total of 90 CHD patients were divided into simvastatin 20mg group (n=37, LDL-C≥2.5mmol/L), simvastatin 10mg group (n=35, 1.8mmol/L≤LDL-C0.05 all; Compared with routine treatment group, there were significant improvement in FMD [(6.01±0.49)% vs. (9.01±0.39)% vs. (9.01±0.47)%，P0.05 all. Conclusion: Simvastatin can increase NO concentration and improve vascular endothelial cell dysfunction in CHD patients. Its mechanism may be related with lipid-lowering effect, but independent of its lipid-lowering effect
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To investigate the relationship between the level of plasma atrial natriuretic peptides(ANP) and doppler echocardiography parameters in patients with left ventricular diastolic dysfunction, the patients were divided into four groups according to echocardiography parameters and their plasma levels of ANP, which were determined simultaneously.The results showed that along with left ventricular diastolic function was impaired, the level of ANP increased.There were significant relationships between the level of ANP and LAD, E/A, LVDd, LVDs, EDV, ESV, IVRT, DT, S/D, LVEF, LVFS, except for Pva and Pva dur. The results of this study suggest that the level of plasma ANP is a reliable marker of left ventricular diastolic dysfunction.