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Title:: Valsartan reverses ventricular remodeling of heart failure patients

作者:: 翟桂兰¹ ; 祝焕林²; 王庆茹¹ ; 赵凤琴¹; 1.锦州医学院附属第一医院心内科；2.解放军第二0五医院内二科，辽宁锦州121001

Author(s):: ZHAI Guilan ; ZHU Huanlin; WANG Qingru; ZHAO Fengqin; 1. Department of Cardiology, First Affiliated Hospital of Jinzhou Medical College, Jinzhou, Liaoning 121001, China. 2. 205 Hospital of PLA, Jinzhou,Liaoning 121001, China

关键词:: 缬沙坦; 心力衰竭; 充血性; 心室重构; 心功能

Keywords:: valsartan; heart failure; congestive ventricular remodelling; cardiac function

分类号:: R972；R541.6

DOI:: -

文献标识码:: A

摘要:: 目的观察缬沙坦对心力衰竭患者心室重构的影响。方法选择充血性心力衰竭患者99例，心功能NYHA Ⅱ～Ⅳ级，左室射血分数（LVEF）<0.45。随机分成A、B、C 3组。A组：为对照组，予硝酸酯制剂、利尿剂、地高辛、β受体阻滞剂等常规治疗。B组：开搏通组，A组治疗+开搏通，目标剂量50 mg，3次/d。C组：缬沙坦组，A组治疗+缬沙坦，目标剂量80 mg，2次/d。疗程均3个月。用药前后测定心脏左室舒张末内径（LVEDD）、左室收缩末内径（LVESD）、相对室壁厚度(RWT)、短轴缩短率（FS）、心搏出量（SV）、LVEF；血清醛固酮（ALD）、内皮素-1（ET-1）、血管紧张素Ⅱ（AngⅡ）。结果 ①C组治疗前后比较，ALD、ET-1 、AngⅡ、LVEDD、LVESD显著降低和缩小（均P<0.05），RWT、LVEF、FS、SV显著增加（P<0.05）。②C组治疗后与A组治疗后比较，ALD、ET-1、AngⅡ、LVEDD、LVESD显著下降（均P<0.05），RWT、EF、FS、SV显著增加（均P<0.05）；③C组治疗后与B组治疗后比较， ALD显著性降低（P<0.05），其它指标差异无显著性（均P>0.05）。结论 ①缬沙坦能降低促使心室重构的ALD、ET-1 、AngⅡ；②缬沙坦能明显逆转心室重构，改善心功能，效果与开搏通相似。

Abstract:: AIM To investigate the effect of valsartan on ventricular remodeling of heart failure patients. METHODS Ninety nine congestive heart failure (CHF) patients (NYHA ⅡⅣ, LVEF<0.45) were randomly divided into three groups: A. control group (routine treatment of nitrate, diuretic, digoxin, βreceptor blocker); B. captopril group (routine treatment plus captopril, target dosage 50 mg, three times per day); C. valsartan group (routine treatment plus valsartan, target dosage 80 mg, two times per day). Left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), relative wall thickness (RWT), fraction shortening(FS), sendout volume (SV), eject fraction (EF), aldosterone (ALD), endothelin1 (ET1) and angiontensinⅡ (AngⅡ) were measured. RESULTS In group C, ALD, ET1, AngⅡ, LVEDD, LVESD decreased significantly (P<0.05), while RWT, EF, FS, SV increased significantly (P<0.05) after the treatment. ② Compared with group A, ALD, ET1, AngⅡ, LVEDD and LVESD were significantly reduced (P<0.05), while RWT, ET, FS and SV significantly increased (P<0.05) in group C. ③ Compared with group B, ALD of group C decreased significantly (P<0.05), while other indexes were not significantly changed. CONCLUSION Valsartan, similar to Captopril, reverses ventricular remodelling by decreasing ALD, ET1and AngⅡ and therefore improves cardiac function.

参考文献/References

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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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