Clinical Analysis of CRT Combined with β Receptor Blocker in the Treatment of Chronic Heart Failure and its Influence on the Cardiac Function of Patients
ZHU Guo-xing, MA Wen-shuai
Department of Cardiology,Chang'an Hospital,Xi'an Shaanxi 710016
Abstract:【Objective】 To investigate the clinical efficacy of cardiac resynchronization therapy (CRT) combined with β receptor blockers in the treatment of chronic heart failure (CHF) and its influence on cardiac function. 【Methods】 The clinical data of 76 patients with CHF admitted to our hospital from July 2017 to February 2020 were analyzed retrospectively, and they were divided into the observation group (CRT combined β receptor blocker treatment, n=36) and control group (β receptor blocker treatment, n=40). The left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were compared between the two groups before treatment and 1, 3 and 6 months after treatment.The levels of serum brain natriuretic peptide (BNP), cardiac troponin I (cTnI), C-reactive protein (CRP), inflammatory factors, tumor necrosis factor a (TNF-α) and interleukin-6 (IL-6) were compared, and the adverse reactions during treatment were recorded. 【Results】 After one month, three months and six months of treatment, LVEF in the observation group was higher than that before treatment, LVEDD and LVESD were lower than that before treatment (P<0.05); LVEF in the control group increased, LVEDD and LVESD decreased, but the difference was not statistically significant (P>0.05). After one month, three months and six months of treatment, the serum BNP, cTnI, CRP, TNF-α and IL-6 levels of patients in the observation group were lower than those before treatment, and those in the observation group were lower than those in the control group, with statistical significance (P<0.05); After 6 months of treatment, the levels of serum TNF-α and IL-6 in the control group were lower than those before treatment, and the difference was statistically significant (P<0.05). Both groups had symptoms of fatigue, limb cooling, bradycardia and gastrointestinal discomfort during treatment, but there was no significant difference between the two groups (P>0.05). 【Conclusion】 CRT combined with β receptor blocker can significantly improve the cardiac function of patients with chronic heart failure, reduce the level of inflammatory factors, and do not increase adverse reactions, which is worthy of clinical promotion.
朱国兴, 马文帅. CRT联合β受体阻断剂治疗慢性心力衰竭的临床疗效及对患者心功能的影响[J]. 医学临床研究, 2022, 39(11): 1604-1607.
ZHU Guo-xing, MA Wen-shuai. Clinical Analysis of CRT Combined with β Receptor Blocker in the Treatment of Chronic Heart Failure and its Influence on the Cardiac Function of Patients. JOURNAL OF CLINICAL RESEARCH, 2022, 39(11): 1604-1607.
[1] EDELMANN F,KNOSALLA C,K MÖRIKE,et al. Chronic heart failure[J].Dtsch Arztebl Int,2018,115(8):124-130. [2] 董洪玲,王中鲁,张亮,等. 慢性心力衰竭的治疗进展[J].中国循证心血管医学杂志,2017,9(2):246-248. [3] 邱伯雍,王永霞. 慢性心力衰竭流行病学及防治研究进展[J].中华实用诊断与治疗杂志,2017,31(6):619-621. [4] KUTYIFA V.Comparison of long-term survival benefits with cardiac resynchronization therapy in patients with mild heart failure with versus without diabetes mellitus from the multicenter automatic defibrillator implantation trial with cardiac resynchronization therapy(MADIT-CRT)[J].Am J Cardiol,2018,121(12):1567-1574. [5] 中国全科医学网.《2018 NICE成人慢性心力衰竭诊断与管理指南》心力衰竭管理更新要点[J].实用心脑肺血管病杂志,2019,27(3):16. [6] 董浩,门素珍,马丽娟,等. 利钠肽系统与肾素-血管紧张素-醛固酮系统在心力衰竭中交互作用[J].现代生物医学进展,2017,17(13):187-190. [7] 晁鹏,任澎. JAK/STAT信号转导通路与心力衰竭的研究进展[J].心血管病学进展,2017,38(6):729-735. [8] 沈伟伟,于俊民. 心肌梗死后心肌纤维化分子机制研究进展[J].医学综述,2017,23(7):1249-1253. [9] 蒋桔泉,丁世芳. 急性心肌梗死后β受体阻滞剂的应用进展[J].临床内科杂志,2017,34(4):284-286. [10] BOCZAR K,SAWUTA A,ZBEK A,et al. Cardiac resynchronization therapy with His bundle pacing as a method of treatment of chronic heart failure in patients with permanent atrial fibrillation and left bundle branch block[J].J Electrocardiol,2018,51(3):405-408. [11] VALENZA G,WENDT H,KIYONO K,et al. Mortality prediction in severe congestive heart failure patients with multifractal point-process modeling of heartbeat dynamics[J].IEEE Trans Biomed Eng,2018,65(10):2345-2354. [12] SUDHARSHAN S,NOVAK E,HOCK K,et al. Use of biomarkers to predict readmission for congestive heart failure[J].Am J Cardiol,2016,119(3):445-451.