卡维地洛对慢性充血性心力衰竭患者心功能及心率变异性的影响

目的　观察卡维地洛对慢性充血性心力衰竭 (CHF)患者心功能和心率变异性 (HRV)的影响。方法　 63例CHF患者随机分为两组 ,在心衰常规用药的基础上 ,卡维地洛由小剂量开始 ,逐渐递增至目标剂量。治疗前及治疗 6月后测定心功能及HRV指标。结果　治疗 6月后卡维地洛组与对照组比较 ,左室舒张末期内径 (LVEDD)、左室收缩末期内径 (LVESD)显著下降 (P <0 0 5 ) ,左室射血分数 (LVEF)显著增加 (P <0 0 5 ) ;心率变异性指标全部窦性心律R -R间期的标准差 (SDNN) ,全程连续 5minR -R间期标准差的平均值 (SDANN) ,全部相邻R -R间期差值的均方根 (rMSSD) ,相邻RR间期差值 >5 0ms的百分比 (PNN5 0 ) ,低频率段功率 ( 0 0 4～ 0 15Hz) (LF) ,高频率段功率 ( 0 15～ 0 40Hz) (HF)显著增加 ( P <0 0 5 ) ,LF/HF比值显著下降 ( P <0 0 5 )。结论　卡维地洛加心衰常规治疗 ,在改善CHF患者心功能的同时显著改善HRV ,从而改善自主神经的平衡性 ,改善患者的预后

The Influences of Carvedilol on Cardiac Function and Heart Rate Variability in Patients with Congestive Heart Failure

Objective To observe the effect of carvedilol on cardiac function and heart rate variability(HRV) in patients with congestive heart failure(CHF) . Methods Sixty-three patients with CHF were randomly divided into two groups. 33 cases (carvedilol group) were given Carvedilol titrated from low dose to target dose in addition to standard therapy for CHF. The cardiac fuction and HRV of all patients were examined before and after 6 months therapy. Results After 6-month therapy, LV end-diastolic dimension (LVEDD) and LV end-systolic dimension (LVESD) in carvedilol group were significantly lower than those in control group (P<0 05),and LV ejection fraction (LVEF) was remarkably higher (P<0 05). After treatment, standard deviation of all means of 5-minutes R-R intervals all over 24 hours (SDANN), root mean square of successive R-R differences (rMSSD), percentage of adjacent differences more than apart (PNN50), low frequency (LF), and high frequency (HF) in carvedilol group were obviously higher than those in control group (P<0 05),and LF/HF was remarkably lower (P<0 05). Conclusion Carvedilol may improve cardiac function and HRV in patients with congestive heart failure.