Effects of bisoprolol different taking timeon circadian rhythm of heart rate and neuroendocrine factors in patients with chronic heart failure / 药物评价研究

ABSTRACT

Objective Toinvestigate the effects of bisoprolol different taking timeon circadian rhythm of heart rate and neuroendocrine factors in patients with chronic heart failure.Methods A total of 96 patients with chronic heart failure and 50 healthy subjects were enrolled as the case group and the control group,and the case group were divided into day taking medicine group (700-800) and night taking medicine group (1900-2000) according to different administration time ofbisoprolol,48 cases in each group.The dynamic ECG results,plasma norepinephrine (NE),angiotensin Ⅱ (Ang Ⅱ),aldosterone and epinephrine levels were compared between the case group and the control group,and the changes of the above indexes before and after treatment were compared between the 2 subgroups.Results Compared with the control group,in the case group,the heart rate of 24 h was significantly accelerated (P ＜ 0.05).The ratio of heart day and night rate increased,and non dipper heart rate increased significantly (P ＜ 0.05);the levels of NE,AngⅡ,aldosterone and epinephrine increased significantly (P ＜ 0.05),and there was no circadian rhythm in the neuroendocrine factors in the case group (P ＞ 0.01).Compared with the before treatment,the heart rate of 24 h were significantly slower in the day taking medicine group and the night taking medicine group (P ＜ 0.05),the rate of heart rate decreased day and night,non dipper heart rate reduction,the levels ofNE,AngⅡ,aldosterone and epinephrine decreased obviously (P ＜ 0.05),and the circadian rhythm was not recovered (P ＞ 0.01).Conclusion Circadian rhythms of heart rate and neuroendocrine factors disappear in patients with chronic heart failure,and taking bisoprolol at night do not significantly restore the circadian rhythm of heart rate and neuroendocrine factors compared with those taken during the day.