Retrospective study on the short-term efficacy of different doses of Spironolactone in patients with heart failure of ischemic cardiomyopath and the influence of ventricular remodeling markers.

OBJECTIVE: To evaluate the impact of varying dosages of Spironolactone on the short-term effectiveness and ventricular remodeling indicators in patients with Heart Failure of Ischemic Cardiomyopathy (HFIC). METHODS: A cohort of 141 HFIC patients, admitted to our hospital between October 2018 and February 2023, were enrolled for this study. Alongside the standard treatment for Chronic Congestive Heart Failure (CHF), these patients were randomly assigned to either a low-dose (20 mg/d, N=70) or a high-dose (60 mg/d, N=71) Spironolactone group. After four weeks, various parameters were assessed and compared within each group before and after the treatment. These parameters included echocardiographic indices (LVEF, LVESD, LVEDD, LVESV, and LVEDV), New York Heart Association (NYHA) cardiac function classification, ventricular remodeling markers (hs-CRP, TNF-α, NT-pro BNP, Gal-3, MMP-9, and TIMP-4), and the Six Minute Walk Distance (6MWD). RESULTS: Both low-dose and high-dose Spironolactone significantly improved LVEF and 6MWD in HFIC patients (P<0.05), as well as markedly reduced LVESD, LVEDD, LVESV, LVEDV, and NYHA cardiac function grades (P<0.05). The high-dose group exhibited the most pronounced improvements (P<0.05). High-dose Spironolactone was more effective in improving the clinical and total effective rate compared to the low-dose, significantly reducing treatment inefficacy (P<0.05). Both dosages significantly increased serum potassium levels within normal ranges. They also improved the expression of ventricular remodeling markers (hs-CRP, TNF-α, NT-pro BNP, Gal-3, MMP-9, and TIMP-4) in HFIC patients, with the high-dose group showing the most significant results (P<0.05). CONCLUSION: High-dose Spironolactone (60 mg/d) demonstrates superior efficacy over the low-dose (20 mg/d) in rapidly diminishing ventricular remodeling damage and enhancing cardiac function and clinical symptoms in HFIC patients over a short duration.

Management of Chronic Congestive Heart Failure Caused by Myxomatous Mitral Valve Disease in Dogs: A Narrative Review from 1970 to 2020.

The treatment of chronic congestive heart failure (CHF), secondary to myxomatous mitral valve disease (MMVD) in dogs, has considerably changed in the last fifty years. An analysis of the literature concerning the therapy of chronic CHF in dogs affected by MMVD is not available, and it is needed. Narrative reviews (NRs) are aimed at identifying and summarizing what has been previously published, avoiding duplications, and seeking new study areas that have not yet been addressed. The most accessible open-access databases, PubMed, Embase, and Google Scholar, were chosen, and the searching time frame was set in five decades, from 1970 to 2020. The 384 selected studies were classified into categories depending on the aim of the study, the population target, the pathogenesis of MMVD (natural/induced), and the resulting CHF. Over the years, the types of studies have increased considerably in veterinary medicine. In particular, there have been 43 (24.29%) clinical trials, 41 (23.16%) randomized controlled trials, 10 (5.65%) cross-over trials, 40 (22.60%) reviews, 5 (2.82%) comparative studies, 17 (9.60%) case-control studies, 2 (1.13%) cohort studies, 2 (1.13%) experimental studies, 2 (1.13%) questionnaires, 6 (3.40%) case-reports, 7 (3.95%) retrospective studies, and 2 (1.13%) guidelines. The experimental studies on dogs with an induced form of the disease were less numerous (49-27.68%) than the studies on dogs affected by spontaneous MMVD (128-72.32%). The therapy of chronic CHF in dogs has considerably changed in the last fifty years: in the last century, some of the currently prescribed drugs did not exist yet, while others had different indications.

The effect of serum uric acid concentration on the severity of chronic congestive heart failure.

This study aimed to investigate the adverse effects of serum uric acid concentration on the severity of chronic congestive heart failure. One hundred patients with chronic congestive heart failure (several risk factors include hypertension, smoking, and diabetes mellitus) were enrolled in this study (51 females and 49 males). Participants were admitted to Alsader Medical City in Al-Najaf from August 2018 to March 2019. Detailed medical history and complete clinical examination were performed for all patients. The patients' ages ranged from 13-90 years, with a mean of 62.1±15.8 years, and the median was 65 years. No statistically significant age difference was observed between males and females (P-value=0.687). Increased serum uric acid had a directly negative effect on the severity of chronic congestive heart failure and hypertension. High serum uric acid concentration was associated with increased severity of chronic congestive heart failure class NYHA III and NYHA IV and a decrement in ejection fraction of the left ventricle.

Higher liver stiffness in patients with chronic congestive heart failure: data from NHANES with liver ultrasound transient elastography.

BACKGROUND: Liver stiffness in patients with chronic congestive heart failure (CCHF) is poorly understood and liver ultrasound transient elastography (LUTE) is a new non-invasive method to detect this condition. In this cross-sectional study we explored liver stiffness and secondary congestive hepatopathy in patients with CCHF detected by LUTE. METHODS: Data from the National Health and Nutrition Examination Survey (NHANES 2017-2018) were analyzed. All participants undergoing LUTE and without liver disease were included, among whom, 110 participants were diagnosed with CCHF. The cut-off values of stiffness for fibrosis and cirrhosis were above 7.65 and 13.01 kPa, respectively. Data regarding liver stiffness were compared between the participants with and without CCHF. RESULTS: Among patients with CCHF, the median liver stiffness was 6.0 kPa, above 7.65 kPa in 32.7% of patients, and above 13.01 kPa in 14.6% of patients. The mean liver stiffness was 5.0 kPa in the control group and was significantly lower than that of patients with CCHF (P<0.001). The ratio of serum albumin/globulin (A/G) gradually decreased according to the liver stiffness of patients with CCHF (P=0.03). CONCLUSIONS: Patients with CCHF had higher liver stiffness values than controls, nearly one-third had substantial fibrosis, and more than one in seven patients progressed to cirrhosis. The A/G ratio may be a potential biomarker for liver stiffness caused by CCHF.

Shear Wave Elastography of Peripheral Muscle Weakness in Patients with Chronic Congestive Heart Failure.

Forty-five study participants (28 chronic heart failure [CHF] patients and 17 control participants) were prospectively enrolled in this study to investigate the clinical potential of ultrasound shear wave elastography (SWE) in identifying peripheral muscle weaknesses in chronic heart failure patients. Muscle stiffness in the gastrocnemius muscle during extension (stretch) and the lower arm flexor muscles during flexion was assessed via shear wave elastography, measuring the shear modulus (kPa) for the resting and contractile states in a range of 0-300 kPa. Resting kPa revealed no significant difference between CHF and CP, but exercise kPa for extension and flexion was significantly lower in CHF than CP. The area under the receiver operating characteristic curve of the denominator kPa-Exercise stretch was 0.916, associated with a sensitivity of 89%, a specificity of 71% and a corresponding cutoff value of 81.1 kPa. Shear wave elastography is thus a reproducible and sensitive ultrasound method for evaluating peripheral muscle deficits in patients with CHF.

Effect of Shenfu Injection on the Expression Profile of Myocardial miRNA in Rats with Chronic Conges-tive Heart Failure / 中国药房

OBJECTIVE:To study the effect of Shenfu injection(SFI)on the expression profile of myocardial miRNA in rats with chronic congestive heart failure (referring to heart failure). METHODS:40 rats were randomly divided into sham operation group (normal saline,ip),model group (normal saline,ip),valsartan group (positive control,10 mg/kg,ig) and SFI group (0.75 mL/kg,im),10 in each group. Except for sham operation group,another groups were reduced heart failure. After modeling, rats in other groups received related medicines,once a day. Affymetrix miRNA V4.0 chip technology was conducted to analyze the miRNA expression in myocardial tissue of rats with heart failure after administration for 28 d,and screen the miRNA on common differential expression in myocardial tissue of rats in each group. The miRNA associated with heart failure was analyzed by thresh-old of differential gene expression multiple value greater than or equal to 1.1. Gene Ontology (GO) analysis was used to analyze functional classification and biological signaling pathway of differentially expressed genes. RESULTS:There were totally 29 miR-Nas on common differential expression and 7 miRNAs associated with heart failure (rno-miR-30c-1-3p, rno-miR-125b-5p, rno-miR-133a-5p,rno-miR-199a-5p,rno-miR-221-3p,rno-miR-146a-5p and rno-miR-1-3p). SFI can significantly downregulate the expressions of rno-miR-125b-5p,rno-miR-133a-5p,rno-miR-221-3p,rno-miR-1-3p in myocardial tissue of rats (P<0.05 or P<0.01). Results of GO analysis showed,miRNAs on differential expression were mainly related to signal transduction,cytoplasm and nucleotide binding. CONCLUSIONS:SFI plays the role of anti-heart failure by participating in the downregulation of miRNAs associated with heart failure process and then affecting related signal pathways transduction after the combination of cyto-plasm and nucleotide.

Activation of corticotrophin releasing hormone-containing neurons in hypothalamic paraventricular nucleus contributes to sympathoexcitation in rats with congestive heart failure / 中国病理生理杂志

AIM: To observe the expression of corticotropin releasing hormone (CRH) within the paraventricular nucleus of hypothalamus (PVN) and to explore the relationship between the activated CRH-containing neurons and sympathetic activity in rats with heart failure (HF).METHODS: Healthy male Sprague-Dawley (SD) rats were subjected to coronary artery ligation to induce HF, and chronic intracerebroventricular (ICV) infusion was performed by osmotic pump for 4 weeks.The rats in sham group and HF group were given vehicle (VEH;artificial cerebrospinal fluid 0.25 μL/h).The rats in HF plus treatment group were treated with CRH competitive inhibitor αh-CRH (15 mg/h).Meanwhile, the Lewis rats and Fischer 344 rats for control study also underwent coronary ligation to induce HF or sham surgery.After 4 weeks, left ventricular end-diastolic pressure (LVEDP) and maximum positive/negative change in pressure over time (±dp/dtmax) were determined.The right ventricular-to-body weight (RV/BW) and lung-to-body weight (lung/BW) ratios were calculated.The renal sympathetic nerve activity (RSNA) was recorded and the plasma norepinephrine (NE) level was measured.The expression of CRH in the PVN combined with the plasma adrenocorticotrophic hormone (ACTH) levels were measured.RESULTS: Compared with the sham-SD rats, the HF-SD rats had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased), accompanied by decreased ±dp/dtmax and increased RSNA, plasma NE, LVEDP, lung/BW and RV/BW.However, ICV treatment with αh-CRH attenuated these changes in the HF-SD rats (P<0.05).Compared with the sham-Fisher 344 rats, the HF-Fisher 344 rats also had a greater number of CRH positive neurons in the PVN (accordingly the plasma ACTH levels were increased).In addition, they had significantly increased RSNA and plasma NE level, higher LVEDP, RV/BW and lung/BW, and lower ±dp/dtmax (P<0.05).Compared with the SHAM-Lewis rats, the HF-Lewis rats had not significantly changed in the above parameters.CONCLUSION: In CHF, the CRH-containing neurons in PVN are activated, thus aggravating cardiac function by increasing sympathoexcitation.

Clinical efficacy of combined beta blocker in the treatment of chronic severe congestive heart failure / 中国生化药物杂志

Objective To investigate the clinical efficacy of combined use of beta blocker in the treatment of chronic severe congestive heart failure (CHF). Methods 78 patients with severe chronic congestive heart failure in patients from November 2015 to January 2017 were randomly divided into study group (n=39) and control group (n=39). The control group was treated with routine treatment of chronic severe congestive heart failure, and the study group was treated with beta blocker metoprolol on the basis of routine treatment. The changes of DBP, SBP, LVEF, LVEDD and the incidence of adverse reactions were recorded before and after treatment in two groups. Results After the analysis of the two groups before treatment, DBP, SBP, LVEF, LVEDD and other indicators compared no significant difference; after the treatment of DBP, SBP, LVEDD group index decline and increase of LVEF were better than the control group, comparing the data with significant difference (P<0.05); drug therapy in the treatment of severe chronic group occurred during the study period the rate of adverse reactions in patients with congestive heart failure and there is no significant difference compared with control group. Conclusion The use of routine regimen based on the use of beta blocker metoprolol can significantly improve the clinical efficacy of patients with chronic severe congestive heart failure, and is conducive to the protection of their prognosis and quality of life.

Clinical efficacy of combined beta blocker in the treatment of chronic severe congestive heart failure / 中国生化药物杂志

Objective To investigate the clinical efficacy of combined use of beta blocker in the treatment of chronic severe congestive heart failure (CHF). Methods 78 patients with severe chronic congestive heart failure in patients from November 2015 to January 2017 were randomly divided into study group (n=39) and control group (n=39). The control group was treated with routine treatment of chronic severe congestive heart failure, and the study group was treated with beta blocker metoprolol on the basis of routine treatment. The changes of DBP, SBP, LVEF, LVEDD and the incidence of adverse reactions were recorded before and after treatment in two groups. Results After the analysis of the two groups before treatment, DBP, SBP, LVEF, LVEDD and other indicators compared no significant difference; after the treatment of DBP, SBP, LVEDD group index decline and increase of LVEF were better than the control group, comparing the data with significant difference (P<0.05); drug therapy in the treatment of severe chronic group occurred during the study period the rate of adverse reactions in patients with congestive heart failure and there is no significant difference compared with control group. Conclusion The use of routine regimen based on the use of beta blocker metoprolol can significantly improve the clinical efficacy of patients with chronic severe congestive heart failure, and is conducive to the protection of their prognosis and quality of life.

Effect of betaloc combined with lotensin on cardiac function and NT-proBNP level in patients with chronic congestive heart failure / 药物评价研究

Objective To analyze the effect ofbetaloc combined with lotensin on cardiac function and N-terminal B type natriuretic peptide (NT-proBNP) level in patients with chronic congestive heart failure (CHF).Methods 210 CHF patients in People's Hospital in Qinghai Province from December 2015 to December 2016 were divided into three groups by random number table,70 cases in each.Three group were given routine examination,cardiotonic and diuretic treatment,and on this basis,control A group purely added lotensin,control B group purely added betaloc,observation goup took betaloc combined with lotensin.The cardiac function,exercise tolerance,NT-proBNP level,concentration of hemoglobin (Hb),heart rate,blood pressure,clinical efficacy and safety before and after treatment were compared among the three groups.Results Before treatment,there was no statistical difference in the cardiac function,NT-pro BNP level and Hb content among three groups;After treatment,the cardiac function and exercise tolerance of observation group were significantly better than those of control A and B group (P ＜ 0.05) The NT-pro BNP level,heart rate and blood pressure of observation group were significantly lower than those of control A and B group (P ＜ 0.05) The Hb content of observation group was higher than that of control A and B group (P ＜ 0.05).The total effective rate of observation group was significantly higher than that of control A and B group (P ＜ 0.05).There was no statistical difference in the incidence of adverse reactions among three groups.Conclusion Betaloc combined with lotensin in treatment of CHF can effectively improve cardiac function,relieve heart failure and increase exercise tolerance of patients,which has clinical application value.

Role of isolated ultrafiltration in the management of chronic refractory and acute decompensated heart failure.

Chronic congestive heart failure (CHF) and acute decompensated heart failure (ADHF) refractory to medical therapy represent therapeutic challenges. In such patients, attempts to reduce pulmonary and systemic congestion frequently produce deterioration of renal function. In studies of patients with chronic severe CHF refractory to medical therapy (including loop diuretics), isolated ultrafiltration was frequently able to relieve congestive symptoms by precise removal of extracellular water and sodium, and in some cases was able to restore responsiveness to loop diuretics. Randomized controlled trials comparing isolated ultrafiltration and medical therapy (mainly loop diuretics) in patients with ADHF failed to demonstrate the superiority of isolated ultrafiltration over diuretic therapy with respect to renal function and mortality. Isolated ultrafiltration reduced length of hospital stay in several studies. At this time, there is insufficient evidence to support the use of isolated ultrafiltration as initial therapy of ADHF.

Potential new drug treatments for congestive heart failure.

INTRODUCTION: The prevalence of heart failure (HF) has increased globally in recent decades. Advances in our understanding of underlying pathophysiologic mechanisms have given rise to new therapies for treating the growing HF population. Nonetheless, morbidity and mortality associated with HF and its financial implications are daunting. Thus, novel therapies that can improve the natural history of HF patients are urgently needed. AREAS COVERED: This article reviews new investigational drugs being developed for the treatment of both acute decompensated heart failure (ADHF) and chronic heart failure with reduced ejection fraction (HFrEF). It presents the background of these drugs with a focus on their mechanism of action, their pharmacology, evidence from clinical studies and their potential role in HF management. EXPERT OPINION: The mortality benefit associated with serelaxin treatment in the RELAX-HF trial is being tested in RELAX-AHF II, while two other drugs, ularitide and TRV027, are also being evaluated in ADHF patients. Two new agents for the treatment of chronic HFrEF, LCZ696 and ivabradine, have been recently been approved for use by the FDA and four novel agents which have shown considerable promise in early studies, omecamtiv mecarbil, vericiguat, finerenone, and neuregulin, are currently being evaluated in late-phase clinical trials.

Effect of Cardiac Resynchronization Therapy in Patients With Chronic Heart Failure Combining Left Bundle Branch Block Conformed to New Diagnostic Standard / 中国循环杂志

Objective: To analyze the effect of cardiac resynchronization therapy (CRT) in patients with chronic heart failure (CHF) combining left bundle branch block (LBBB) conformed to new diagnostic standard. Methods: A total of 19 CHF patients who received CRT in our hospital from 2005-06 to 2013-05 were studied. The patients were divided into 2 groups: True LBBB group,n=13 patients conformed to new diagnostic standard and False LBBB group, n=6 patients conformed to traditional diagnostic standard. Pre- and Post-operative LVEF, LVEDD, QRS duration (QRSd) and IVMD were compared in all patients; post-operative LVEF, LVEDD, QRSd, IVMD and Tmsv16-SD, Tmsv16-Dif were compared between 2 groups. Results: The post-operative LVEF, LVEDD, QRSd and IVMD were improved than pre-operative condition in both groups. Compared with False LBBB group, the improvements were more obvious in True LBBB group as LVEDD by mm (5.95±0.72 vs 7.13±0.78), IVMD by ms (22.45±8.00 vs 27.63±13.09), and QRSd by ms (140.38±5.80 vs 153.68±14.38), all P<0.01. The post-operative LVEF and Tmsv16-SD, Tmsv16-Dif were similar between 2 groups. Conclusion: CHF patients combining either true or false LBBB could be beneift from CRT, while the patients with true LBBB may receive better clinical outcomes from CRT.

Clinical Observation of Atorvastatin Calcium Combined with Metoprolol in the Treatment of Chronic Conges-tive Heart Failure / 中国药房

OBJECTIVE:To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure (CHF). METHODS:207 CHF patients were randomly divided into control group (102 cases) and observation group (105 cases). Control group received cardiac,diuretic,vasodilating and oxygen inhalation,Metoprolol tar-trate tablet with initial dose of 6.25 mg,2-3 times a day,then increased 6.25-12.5 mg based on the improvement,2-3 times a day. Observation group additionally received 80 mg Atorvastatin tablet,twice a day. The treatment course for both groups was 16 w. Clinical efficacy,cardiac functions [left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),mi-tral early diastolic and late diastolic peak flow velocity ratio(E/A)],blood lipids [lipoprotein(a)Lp(a),triglyceride(TG),total cholesterol(TC)] levels before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P0.05). Af-ter treatment,the LVEF and E/A in 2 groups were significantly higher than before,and observation group was higher than control group,LVESD,Lp(a),TG and TC were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P0.05). CONCLUSIONS:Based on conventional treatment,the efficacy of atorvastatin calcium combined with metoprolol is su-perior to metoprolol in the treatment of CHF,with better safety.

Clinical Observation of Chronic Congestive Heart Failure Treated with Buzhong Yiqi Wuling Decoction Com-bined with Western Medicine / 中国药房

OBJECTIVE:To observe the clinical efficacy and safety of Buzhong yiqi wuling decoction combined with western medicine in the treatment of chronic congestive heart failure(CHF). METHODS:120 CHF patients were divided into observation group and control group by random number table method,with 60 cases in each group. Control group received conventional western medicine treatment as rest,low salt diet and diuretics. Observation group was additionally given Buzhong yiqi wuling decoction,one dose a day,at twice,on the basis of control group. Treatment course of 2 groups lasted for 2 weeks. Average TCM symptom score, level of plasma NT-proBNP,6 min walk test(6MWT)distance before and after treatment,clinical efficacy and the occurrence of ADR were compared between 2 groups. RESULTS:Before treatment,there was no statistical significance in average TCM symptom score,level of plasma NT-proBNP and 6MWT distance between 2 groups(P>0.05). After treatment,average TCM symptom score and level of plasma NT-proBNP of 2 groups were decreased significantly,and the observation group was more significant than the control group,with statistical significance(P<0.05);6MWT distance of 2 groups were improved significantly compared to before treatment,and the observation group was significantly longer than the control group,with statistical significance(P<0.05). After treatment,total effective rate of observation group(93.33%)was significantly higher than that of control group(83.33%),with sta-tistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Buzhong yiqi wuling decoction is an ef-fective prescription to treat CHF,and can relieve clinical symptoms,improve the cardiac function,decrease NT-proBNP level and en-hance the patient exercise tolerance with good safety.

Influence and Curative Effect Observation of Carvedilol on Serum Matrix Metalloproteinase -2, 9 and 10 (MMP-2, 9 and 10) in Patients with Chronic Congestive Heart Failure / 中国药师

Objective: To study the influence and curative effect of carvedilol on serum matrix metalloproteinase -2, 9 and 10 (MMP-2, 9 and 10) in the patients with chronic congestive heart failure (CHF). Methods:Totally 76 patients with CHF were select-ed and randomly divided into the observation group and the control group. All the patients were given routine medical treatment, inclu-ding cardiotonic treatment ( digoxin) , diuresis ( thiadiazide) , vascular dilation ( nitrate ester) and so on. The patients in the observa-tion group were additionally given carvedilol for 6 months. The changes of serum MMP-2, 9 and 10 levels in the patients before the treatment and 6 months after the medical treatment were observed, and the curative effect and safety were studied as well. Results:Af-ter the 6-month medical treatment, the serum MMP-2, 9 and 10 levels in all the patients were obviously declined(P<0. 05), and the declining rates in the observation group were much higher than those in the control group(P<0. 05). Meanwhile, the total clinical effi-ciency of the observation group was 94. 74%, which was higher than that of the control group (78. 95%) (P<0. 05). Conclusion:Carvedilol has favorable curative effect and safety in the treatment of CIF, and the underlying mechanism may be relative to the de-crease of serum MMP-2, 9 and 10 levels.

Therapeutic effect of erythropoietin combined oral iron in patients with chronic heart failure accompanied by anemia / 中国综合临床

Objective To explore the therapeutic effect of erythropoietin (EPO)combined oral iron in patients with chronic congestive heart failure( CHF)accompanied by anemia. MethodsNinety six patients with CHF accompanied by anemia, whom were consecutively hospitalized from January 2007 to December 2009, were enrolled into this study. They were randomly divided into treatment group accepted routine anti-heart failure therapy combined EPO and oral iron, and control group solely accepted routine anti-heart failure therapy. After 6 months follow up, the changes of hemoglobin ( Hb ), cardiac function classification, left ventricular ejection fraction(LVEF) ,6-minute walking distance,readmission rate of CHF and cardiac death were compared between two groups. ResultsCompared with those before therapy, we found significant improvements of hemoglobin level ( [ 120. 12 ± 10. 42 ] g/L vs [ 86.40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2. 65 ± 0. 67 vs 3. 13 ±0. 61, P ＜ 0. 01 ), LVEF ( [ 37.21 ± 4. 96 ]％ vs [ 33. 92 ± 7. 28 ]％, P ＜ 0. 01 ), 6-minute walking distance ( [ 443.52 ± 97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in treatment group after EPO combined oral iron administration. After 6 months follow up, we also found significant improvements of Hb level ( [ 120. 12 ±10. 42 ] g/L vs [ 86. 40 ± 14. 30 ] g/L, P ＜ 0. 01 ), cardiac function classification ( 2.65 ± 0. 67 vs 2. 98 ± 0. 81,P＜0.01),LVEF([37.21 ± 4.96]％ vs [34.67 ±4.10]％,P ＜ 0. 01),6-minute walking distance ( [443.52 ±97. 39 ] mvs [ 379. 15 ± 59. 34 ] m, P ＜ 0. 01 ) in the comparison between treatment and control group. The readmission rate of CHF fell significantly in treatment group compared to control (20. 83％ vs 39. 58％ ,P ＜ 0. 05 ). However, we found no significant difference in cardiac death rate ( 0％ vs 4. 17％, P ＞0. 05). ConclusionTreatment of EPO combined oral iron could significantly improve the cardiac function,increase exercise tolerance,lower the readmission rate of CHF in patients with chronic congestive heart failure (CHF)accompanied by anemia.

Preliminary Study of Microarray Gene Expression Profiles in Chronic Congestive Heart Failure due to Rheumatic Heart Disease / 中国循环杂志

Objective:To analyze gene expression profiling of left ventricular myocardium in patients with chronic congestive heart failure(CHF)caused by rheumatic heart disease(RHD)with the normal controls in order to identify CHF associated target genes. Methods:The gene expression profiles of left ventricular myocardium from patients with CHF by RHD and normal controls were obtained from six human whole-genomic oligonucleotide microarrays(Affymetrix HG U133 Plus 2.0 GeneChip). GeneSpring software was used to identify the differentially expressed genes in both groups,and bioinformatic analysis was applied to analyze the target genes associated with CHF. Real-time PCR was carried out to validate the expression of three target genes. Results:We identified 102 target genes associated with CHF which were classified into 7 gene clusters. Microarray results were further confirmed by real time PCR for three genes. ATF3 was markedly down-regulated,IGFBP2 and NPPB were notably up-regulated in the left ventricular myocardium samples from CHF patients. Conclusion:A lot of differentially expressed genes,obtained by using the whole-genomic expression profiling technology,might be a contributory factor for the initiation and progression of CHF and it helpful for the understanding of underlying pathophysiological implications. Further investigation on these genes would provide a strategy to identify genetic markers and molecular events associated with CHF caused by RHD.

Nursing of patients with chronic congestive heart failure treated with local renal nerve block / 中国实用护理杂志

Objective To summarize the nursing methods for patients with chronic congestive heart failure treated with local renal nerve block. Methods 10 cases of patients with chronic congestive heart failure were treated with renal nerve block. The blood and urine electrolytes, plasma neuroendocrine hor-mones, the 24-hour urine volume were measured before and after the renal nerve block to calculate the rate of excretion of urinary sodium. The changes of the heart rate and blood pressure and the improvement of the dyspnoea, swelling and other symptoms of heart failure were monitored continuously before and after the re-nal nerve block. Results There was a significant increase in the 24-hour urine volume and the rate of excretion of urinary sodium in the patients with heart failure after the renal nerve block (P<0.05),and there was a significant decrease in the amount of plasma neuroendocrine hormones after the renal nerve block (P<0.01);there was no signifieant changes in the heart rate and the average blood pressure with improvement of dyspnoea, swelling and other symptoms of heart failure. No significant complications were found. Conclusions The nursing measures taken by the nurses in the clinical application of local renal nerve block as a new treatment modality to the treatment of patients with chronic congestive heart failure are safe, effective and feasible.

Influence of aspirin on the efficacy of captopril in the treatment of chronic congestive heart failure / 中国临床药理学与治疗学

AIM: To investigate the influence of aspirin on the efficacy of captopril in the treatment of chronic congestive heart failure (CHF). METHODS: 74 cases of CHF were divided into 2 groups depending on whether aspirin was administrated before captopril was given, then all patients were given captopril 12.5 - 25 mg , tid, for 28 days. RESULTS: In aspirin group, marked effective rate was 46.7 %, and total effective rate was 70%, superior to that in no aspirin group (P