替米沙坦对扩张型心肌病的心室重构及心功能的影响

Effects of telmisartan on reverse remodeling and improvement of cardiac function in patients with dilated cardiomyopathy

目的探讨替米沙坦对扩张型心肌病(dilatedcardiomyopathy,DCM)患者的心室重构和心功能的影响。方法扩张型心肌病患者181例,随机分为对照组59例,进行常规治疗;替米沙坦组62例,在常规治疗的基础上给予替米沙坦80mg/d;培哚普利组60例,在常规治疗的基础上给予培垛普利4mg/d。连续观察1年。治疗前和治疗后6个月及1年,用美国GE.VIVID7型彩色多普勒超声论断仪测定左心室心肌质量(leftventricularmyocardialweight,LVMW),左心室射血分数(leftventricularejectionfraction,LVEF)和左心室后壁收缩期增厚率(△T%),以评价替米沙坦对扩张型心肌病患者心室重构和心功能的影响。结果与治疗前相比,长期服用替米沙坦或培哚普利可使扩张型心肌病的LVEF和△T%明显上升,而LVMW明显下降,用药1年作用更显著(P<0.01),对照组治疗前后无显著变化。结论替米沙坦能明显改善扩张型心肌病患者的心室重构和左心室收缩功能。

Objectives To evaluate the effects of telmisartan on reverse ventrieular remodeling and improvement of cardiac function in patients with dilated cardiomyopathy（DCM）. Methods The study was designed as a randomized, eontrel trial. One hundred and eighty-one patients with DCM were divided into three groups（59 patients in control group, 62 patients in telmisartan group, and 60 patients in pefindopril greup）receiving routine therapy or routine therapy plus telmisartan （80 mg/d） and plus pefindopfil（4 mg/d） for one year. The data of ventrieular function and remodeling （including LVMW, LVEF and △T%）were measured by eehocardiography in the DCM patients at baseline, 6 and 12 months after treatment. Results Long-term therapy in DCM with telmisartan or pefindopfil could increase LVEF and △T% remarkably, and decrease LVMW, at 12-month compared with that baseline（P〈0.01）. The curative effect of telmisartan showed better than that of perindopril. Conclusions Telmisartan can reverses ventricular remodeling and improve left ventrieular systolic function in patients with DCM.