比索洛尔对冠心病心力衰竭患者心室重塑和心功能的影响

目的 :探讨比索洛尔对冠心病心力衰竭患者心室重塑及心功能的影响。方法 :冠心病心力衰竭患者 12 0例 ,左室射血分数≤ 45 % ,心功能 (NYHA)Ⅱ -Ⅳ级 ,常规治疗基础上随机分为比索洛尔治疗组和对照组。治疗 6个月 ,观察比索洛尔对心室重塑、心功能的影响。应用心脏彩色超声仪测定基线值及 1个月、3个月、6个月左室结构及功能指标变化。结果 :比索洛尔平均用量为 (7 5 0± 2 5 0 )mg/d ,经过 6个月治疗 ,比索洛尔治疗组症状和心功能改善 ,与对照组比较左室射血分数上升 [(4 9 2± 2 8) %VS(3 9 6± 3 6) % ,P <0 0 5 ] ,左室收缩末容积下降[(15 7 7± 42 6)mlVS(180 9± 3 9 6)ml] ;与基线比较左室舒张末容积下降 (P <0 0 5 )。结论 :在强心、利尿、血管紧张素转化酶抑制剂基础上 ,应用比索洛尔能显著改善冠心病心力衰竭患者的心功能 ,改善心室重塑。长期应用可改善衰竭心脏心肌细胞的生物学效应 ,这种有益的作用在不同心功能级别间无显著性差异

The effects of bisoprolol therapy on the left ventricular remodeling and function in the patients with coronary heart disease and cardiac dysfunction

Objective: To investigate cardiac function improvement and remodeling process with titrated Bisoprolol therapy in the patients of coronary artery disease with cardiac dysfunction.Methods: In 120 patients with cardiac dysfunction,the ejection fraction was≤0.45.On a basic medical therapy including digitalis,diuretics and ACEI,they were divided randomly into Bisoprolol group and control group for a 6 month follow up period.The data of ventricular function were measured by 2D echocardiography at bsaeline,1,3 and 6 months after admission.Results: The mean dose of Bisoprolol was titrated to (7.5±2 5)mg/day.In Bisoprolol group symptom scores and NYHA class improved,as reflected by the increased left ventricular ejection fraction[(49 2±2 8)%VS (39.6±3 6)%]( P <0 05) and the decreased left ventricular and systolic volume[(157 7±42 6)ml VS (180 9±39 6)ml] compared with those in control group.Moreover,in treatment group,the left ventricular end diastolic volume decreased at 6 month compared with that at baseline( P <0 05),but there ere no significant differences between the two groups.Conclusion: Based on the medication of digitalis,diuretics and angiotensin converting enzyme inhibitors,Bisoprolol therapy can improve left ventricular peerformance,reveres LV remodeling in patients of coronary artery disease with heart failure and also improve the biological properties of the chronically filing heart.There was no difference of this benefit in the patienst with different NYHA classes