Efficacy and safety of Yangxinshi tablet for chronic heart failure:A systematic review and meta-analysis

BACKGROUND The specific benefits of Yangxinshi tablet(YXST)in the treating chronic heart failure(CHF)remain uncertain.AIM To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.METHODS Randomized controlled trials(RCTs)investigating YXST for CHF treatment were retrieved from eight public databases up to November 2023.Meta-analyses of the included clinical studies were conducted using Review Manager 5.3.RESULTS Twenty RCTs and 1845 patients were included.The meta-analysis results showed that the YXST combination group,compared to the conventional drug group,significantly increased the clinical efficacy rate by 23%[relative risk(RR)=1.23,95%CI:1.17-1.29],(P<0.00001),left ventricular ejection fraction by 6.69%[mean difference(MD)=6.69,95%CI:4.42-8.95,P<0.00001]and 6-min walk test by 49.82 m(MD=49.82,95%C:38.84-60.80,P<0.00001),and reduced N-terminal pro-Btype natriuretic peptide by 1.03 ng/L[standardized MD(SMD)=-1.03,95%CI:-1.32 to-0.74,P<0.00001],brain natriuretic peptide by 80.95 ng/L(MD=-80.95,95%CI:-143.31 to-18.59,P=0.01),left ventricular end-diastolic diameter by 3.92 mm(MD=-3.92,95%CI:-5.06 to-2.78,P<0.00001),and left ventricular endsystolic diameter by 4.34 mm(MD=-4.34,95%CI:-6.22 to-2.47,P<0.00001).Regarding safety,neither group reported any serious adverse events during treatment(RR=0.54,95%CI:0.15-1.90,P=0.33).In addition,Egger's test results indicated no significant publication bias(P=0.557).CONCLUSION YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile,suggesting its potential as a therapeutic strategy for CHF.

Effect of Luhong formula on the cardiac rehabilitation of patients with chronic heart failure

BACKGROUND Current treatments for chronic heart failure(CHF)are therapeutically ineffective.The optimization of treatments for this disease needs to be explored and analyzed.AIM To analyze the effect of using Luhong Formula in the cardiac rehabilitation of patients with CHF and its influence on cardiopulmonary function(CPF)and prognosis.METHODS In total,160 patients with CHF admitted between June 2022 and June 2023 were selected,including 75 receiving perindopril(control group)and 85 receiving Luhong Formula(research group).We conducted comparative analyses on the curative effects of traditional Chinese medicine(TCM)syndromes and cardiac function,CPF[oxygen consumption at the anaerobic threshold(VO2 AT)and at peak exercise(peak VO2)],echocardiographic indexes[left atrial volume index(LAVI),left ventricular muscle mass index(LVMI),left ventricular ejection fraction(LVEF)],and prognosis[major adverse cardiovascular events(MACEs)at 6 months follow-up].RESULTS The research group showed markedly higher curative effects of TCM syndromes and cardiac function than the control group.In addition,post-treatment VO2 AT,peak VO2,LVMI and LVEF in the research group were significantly higher,whereas LAVI was significantly lower,than those of the control group.Furthermore,fewer patients in the research group developed MACEs at the 6-month follow-up.CONCLUSION Luhong Formula is more therapeutically effective than perindopril for the cardiac rehabilitation of patients with CHF,specifically in enhancing CPF and prognosis.

Cardioprotective effects of glucagon-like peptide 1 receptor agonists in heart failure: Myth or truth?

Therapy with glucagon-like peptide 1(GLP1)receptor agonists has raised great interest for its beneficial cardiovascular effects in preventing atherosclerosis and heart failure-related outcomes.However,while evidence about atherosclerosis consistently suggests a cardioprotective potential with class effect,controversies remain on its impact on heart failure.GLP1 receptor agonists appear to prevent hospitalization for new-onset heart failure and reduce symptoms in heart failure with preserved ejection fraction(as demonstrated by the recent STEP-HFpEF Trial).Still,GLP1 agonism has resulted in neutral or even harmful effects in patients with established heart failure with reduced ejection fraction(the LIVE trial).GLP1 receptor agonists benefit the cardiovascular system indirectly through their marked metabolic effects(improved weight management,glycemic control,blood pressure,systemic and tissue inflammation),while direct effects on the heart have been questioned.Nonetheless,weight loss alone achieved through GLP1 receptor agonists has failed in improving left ventricular functions.Tirzepatide is a dual agonist of GLP1 and glucose-dependent insulinotropic polypeptide,representing an innovative treatment option in diabetes with a major impact on weight loss and promising cardiovascular benefits.Whether this class of therapies is going to change the history of heart failure is an ongoing debate.

Clinical intervention effect of Xuefu Zhuyu decoction on chronic heart failure complicated with depression

BACKGROUND The diagnosis and treatment of depression in patients with chronic heart failure(CHF)is challenging,with no ideal treatment at present.AIM To analyze the clinical intervention effect of Xuefu Zhuyu decoction(XFZYD)on CHF complicated with depression.METHODS The study cohort comprised 116 patients with CHF complicated with depression who received treatment from July 2020 to July 2023,of which 55 received Western medicine(control group)and 61 received XFZYD(research group).Data on clinical effectiveness,traditional Chinese medicine(TCM)syndrome score,cardiac function,negative emotions,and serum inflammatory factors,were collected for comparative analyses.RESULTS Compared with the control group,the research group had an evidently higher total effective rate.Furthermore,there were marked reductions in TCM symptom score,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,Self-Rating Depression Scale,Hamilton Depression Scale,high-sensitivity C-reactive protein,monocyte chemoattractant protein-1,and matrix metalloproteinase-9 in the research group after treatment,and these were lower than the corresponding values in the control group.Left ventricular ejection fraction was increased and higher in the research group compared with the control group after treatment.CONCLUSION Our findings conclusively proved that XFZYD was considerably superior to Western medicine for treating CHF complicated with depression because it significantly alleviated patients’symptoms,improved cardiac function,relieved negative emotions,and reduced the levels of serum inflammatory factors.

Lyophilized recombinant human brain natriuretic peptide for chronic heart failure:Effects on cardiac function and inflammation

BACKGROUND Chronic heart failure(CHF)is a serious and prevalent condition characterized by impaired cardiac function and inflammation.Standard therapy for CHF has limitations,prompting the exploration of alternative treatments.Recombinant human brain natriuretic peptide(BNP)has emerged as a potential therapy,with evidence suggesting that it can improve cardiac function and reduce inflammation in patients with CHF.However,further research is required to determine the efficacy and safety of lyophilized recombinant human BNP in CHF patients and its impact on microinflammatory status.This study aimed to investigate the effects of lyophilized recombinant human BNP therapy on CHF patients’cardiac function and microinflammatory status.AIM To investigate the effects of freeze-dried recombinant human BNP therapy on cardiac function and microinflammatory status in patients with CHF.METHODS In total,102 CHF patients admitted to our hospital from January 2021 to January 2022 were randomly assigned to control and observation groups(n=51 patients/group).The control patients were treated with standard HF therapy for 3 d,whereas the observational patients were injected with the recombinant human BNP for 3 d.Clinical efficacy,inflammatory factor levels,myocardial damage,cardiac function before and after the treatment,and adverse reactions during treatment were compared between the two groups.RESULTS The overall clinical efficacy was higher in the observation group than in the control group.Compared with baseline,serum hypersensitive C-reactive protein,N-terminal proBNP,and troponin I level,and physical,emotional,social,and economic scores were lower in both groups after treatment,with greater reductions in levels and scores noted in the observation group than in the control group.The overall incidence of adverse reactions in the observation group was not significantly different compared with that in the control group(P>0.05).CONCLUSION Freeze-dried recombinant human BNP therapy can improve heart function and enhance microinflammatory status,thereby improving overall quality of life without any obvious side effects.This therapy is safe and reliable.

Correlation between the Six-Minute Walk Test and Subjective Functional Class in Patients with Heart Failure

Introduction: The Six-Minute Walk Test (6MWT) is an inexpensive method to objectively evaluate physical capacity or limitation and stratify prognosis in patients with Heart Failure (HF). Since the clinical perception of symptoms may be adapted or compromised, regular evaluation from medical interviews often fails to determine functional classification. This study aimed to assess the correlation between New York Heart Association Functional Class (NYHA-FC) and the distance walked in the 6MWT. Methods: We conducted a cross-sectional observational study that included patients with HF with reduced ejection fraction followed up at an outpatient service of a teaching hospital, from August 2018 to April 2019. Patients in NYHA-FC I, II, or III were included. We compared NYHA-FC subjectively obtained during the consultation with the 6MWT performed after medical consultation, and the correlation between these two parameters was assessed. Results: The study included 70 patients with HF, 41 (58.6%) of whom were female. The mean age was 61.2 ± 12.7 years. The most prevalent etiologies were dilated idiopathic cardiomyopathy (35.7%) followed by ischemic cardiomyopathy (25.7%). The mean ejection fraction was 34.1% ± 9.8%. The average distance walked in the 6MWT by NYHA-FC I patients was 437.8 ± 95.8 meters, NYHA-FC II 360.1 ± 96.4, and NYHA-FC III 248.4 ± 98.3. Functional class measured by the 6MWT was different than that estimated by NYHA-FC in 34 patients (48.6%), 23 (32.9%) for a higher functional class and 11 (15.7%) for a lower one (p = 0.07). Pearson’s correlation coefficient between NYHA-FC and the 6MWT was -0.55. Conclusion: There was a moderate correlation between the subjective NYHA-FC and the 6MWT. The 6MWT revealed a different classification from NYHA-FC in almost half of the patients. Among those who presented discrepancies between methods, 6MWT reclassification towards a higher functional class was more common.

An Assessment of Cardiovascular Functional Capacity of a Group of Chronic Heart Failure Patients Using the 6-Minute Walk Test in a Cameroonian Urban Setting

Background: Chronic heart failure is a public health problem worldwide. It has a high mortality rate and is accompanied by a decreased functional capacity and alteration of the quality of life. Objective: This study aimed to assess the cardiovascular functional capacity of a group of patients suffering from heart failure using the 6-minute walk test (6 MWT). Methods: This was a cross-sectional study carried out in the cardiology unit of Douala’s general hospital for 4 months. We included all eligible patients aged 18 years or more who had stable chronic heart failure and gave informed consent. Those who had an acute coronary syndrome (≤1 month), tachycardia (HR ≥ 120 bpm), high blood pressure (SBP ≥ 180 mmHg and/or DBP ≥ 100 mmHg) and reduced mobility due to orthopaedic reasons were excluded. A 6 MWT was done according to the American Thoracic Society guidelines. The 6 MWT result was considered poor for - 450 m and good for >450 m. Results: We recruited a total of 81 patients (61.7% women) with a mean age of 65.9 ± 10.6 years. The most frequent risk factor for heart failure was high blood pressure (77.8%), alcohol consumption(69.1%) and a sedentary lifestyle (53.1%). The left ventricular ejection fraction was mostly preserved (42.0%) or mildly altered (46.9). The 6 MWT results were poor in 55.6% of cases, average in 19.8% of cases and good in only 24.7% of cases. More than half (59.3%) of the participants perceived the effort as being difficult. The cardiovascular functional capacity was significantly associated with age, heart failure stage and physical activity (p Conclusion: Most patients suffering from chronic stable heart failure in the general hospital of Douala have poor cardiovascular functional capacity.

Protective Role of Wumen Jianzhong Qiangxin Granules in Rats with Post-myocardial Infarction Heart Failure and Effect on Myocardial Energy Metabolism

[Objectives]The paper was to determine the effect of Wumen Jianzhong Qiangxin granules(WJQG)on myocardial energy metabolism in a chronic heart failure rat model after myocardial infarction(MI).[Methods]Totally 40 normal male SD rats were randomly divided into sham operation group,model group,trimetazidine group and WJQG group(n=10).The model of MI was established by ligation of the left anterior descending branch except sham operation group.The rats in trimetazidine and WJQG groups were gavaged with 60 mg/kg and 16 g/kg emodin daily,respectively.After administration for 4 weeks,the changes in heart rate(HR),R-R interval(RRI),systolic arterial pressure(SAP),diastolic arterial pressure(DAP),mean arterial pressure(MAP),pulse pressure(PP),left ventricular end-diastolic pressure(LVEDP),rates of maximum positive left ventricular pressure development(+dp/dtmax)and rates of maximum negative left ventricular pressure development(-dp/dtmax)were analyzed.Morphology of myocardial tissues was observed by HE staining,the levels of myocardial tissue adenosine triphosphate(ATP)and glucose transporter type 4(GLUT-4)were determined using scientific research kit,and the expressions of mitochondrial creatine kinase(mit-CK),creatine kinase MM isoenzyme(CK-MM)and adenine nucleotide translocator(ANT)in myocardial tissues were determined by Western blotting.[Results](i)Compared with sham group,LVEDP obviously increased,while+dp/dtmax and-dp/dtmax significantly decreased in model group,with extremely significant difference in statistics(P<0.01).Compared with model group,LVEDP decreased,while+dp/dtmax and-dp/dtmax increased in trimetazidine group and WJQG group,with significant difference in statistics(P<0.05 orP<0.01).(ii)The cardiomyocytes ultrastructure of rats in sham group was normal,while in model group,extensive focus of MI can be seen under optic microscope.In the infarction focus,we can see outline of the necrotic tissue,infiltration of inflammatory cells,few fibroblasts,as well as the slow growth of granulation tissue.Focus of MI in both trimetazidine group and WJQG group were located in a certain part.In the infarction focus,we can see living myocardial cells distributing as islands and islets,more fibroblasts than in model group,as well as active hyperplasia of granulation tissue.(iii)Compared with sham group,the levels of myocardial tissues ATP and GLUT-4 in left ventricular myocardial cells in model group went down,with extremely significant difference(P<0.01).Compared with model group,the levels of myocardial tissues ATP and GLUT-4 in left ventricular myocardial cells in both trimetazidine group and WJQG group went up,with extremely significant difference(P<0.05).(iv)Compared with sham group,the expression level of CK-MM,mit-CK and ANT in left ventricular myocardial cells in model group went down,with extremely significant difference(P<0.01 orP<0.001).Compared with model group,the expression levels of CK-MM,mit-CK and ANT in left ventricular myocardial cells in both trimetazidine group and WJQG group went up,with extremely significant difference in statistics(P<0.05 orP<0.01 orP<0.001).[Conclusions]WJQG can effectively increase the levels of myocardial tissues ATP and GLUT-4,as well as the expression levels of CK-MM,mit-CK and ANT of rats with heart failure after MI,and thus enhance the full exchange between ATP and ADP on the inner membrane of mitochondria conducted by ANT.The prescription also helps to ensure myocardial energy supply and remodel the process of myocardial energy metabolism,and finally protects the cardiac function of rats.

Analysis of the Diagnostic Value of Echocardiography in Patients with Chronic Heart Failure

Objective:This study aims to analyze the diagnostic value of echocardiography in patients with chronic heart failure.Methods:30 patients with chronic heart failure admitted to our hospital during January 2021 to January 2023 were selected as the observation group,and 30 healthy people who received physical examination in our hospital during the same period were selected as the reference group.Both groups received echocardiography,and the results of the ultrasound examination were compared,and the subjects in the observation group were grouped according to the New York Heart Association(NYHA)cardiac function grading standard.The results of echocardiography in patients with chronic heart failure of different cardiac function grades were compared.Results:The left ventricular ejection fraction(LVEF)and ratio of maximum blood flow in the early diastole(E)to movement speed(A)(E/A)in the observation group were lower than those in the reference group,while the left ventricular posterior wall thickness(LVPWd),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left atrial diameter(LAD),and interventricular septal thickness(IVS)were higher than those of the reference group(P<0.05).With the continuous increase of cardiac function grades,the levels of LVEF and E/A in patients with chronic heart failure continued to decrease,while the levels of LVPWd,LVEDD,LVESD,LAD,and IVS continued to increase,and there were significant differences among the groups(P<0.05).Conclusion:The application of echocardiography in the clinical diagnosis of chronic heart failure can accurately evaluate the changes of cardiac shape and cardiac function,and provide a reliable basis for clinical diagnosis with a high application value.

Development of Nursing Protocol for Preventing Discontinuation of Treatments by Methods Other than Physical Restraint during Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function

The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.

Serum uric acid as an index of impaired renal function in congestive heart failure

BackgroundHyperuricemia 经常是在有心失败的病人的现在。许多病理学的条件例如织物局部缺血，肾的功能缺陷，心脏的功能缺陷，新陈代谢的症候群，和煽动性的地位，可以影响尿酸(UA ) 新陈代谢。这研究是回顾地在心 failure.MethodsWe 估计他们的潜在的关系到 UA 新陈代谢估计的临床的特征， echocardiological ，肾，与充血的心失败在随机选择的成年人的一个大队在心血管的疾病和 UA 新陈代谢根据他们的参与的以前的证据选择的新陈代谢、煽动性的变量( n = 553 )。由索引聚类，那些变量用因素 analysis.ResultsIn 因素分析被探索，尿酸(SUA ) 形成了的浆液包括了浆液 creatinine (SCr ) 和血脲氮(甜面包) 的肾的功能的变量的主要的簇的部分。在有充血的心失败的病人的变量之间的 Univariate 关联系数证明为 SUA 的最强壮的关联与甜面包(r = 0.48， P &#x0003c；0.001 ) 并且 SCr (r = 0.47， P &#x0003c；0.001 ).ConclusionsThere 是在 SUA 层次和在有充血的心失败的病人的肾的功能的措施之间的一种反的关系。在 SUA 和 SCr 和甜面包层次之间的强壮的关联建议提高的 SUA 集中在心失败反映肾的功能的一个缺陷。

Improvement of cardiac function and reversal of gap junction remodeling by Neuregulin-1β in volume-overloaded rats with heart failure

ObjectiveWe 用 Neuregulin-1&#x003b2 执行了实验；(NRG-1&#x003b2；) 决定为保护的角色的机制由在 .MethodsRat HF 建模的心失败(HF ) 期间改变差距连接(GJ ) 源于它的有益的效果的处理被 aortocaval 建立管。48 只老鼠随机被划分成 HF (HF， n = 16 ) ， NRG-1&#x003b2；处理(NRG， n = 16 ) ，并且假冒的操作(S， n = 16 ) 组。在 NRG 组的老鼠是管理 NRG-1&#x003b2；(10 &#x000b5； g/kg 每天) 为经由尾巴静脉的 7 天，而另外的组与一样的剂量被注射盐。在操作以后的 12 个星期，在从左室获得的单个 myocytes 的 Connexin 43 (Cx43 ) 表示被 immunocytochemistry 决定。全部的蛋白质为 immunoblotting 试金从冻结的左室的纸巾被提取，并且 myocytes 的超微结构被传播电子 microscopy.ResultsCompared 与 HF 组，一起观察在 NRG 组的老鼠的心脏的功能显著地被改进的、不规则的分发和死亡 Cx43 表示被减轻。myocytes 的超微结构严重在 HF 老鼠，和 NRG-1&#x003b2 被损坏；减少了这些病理学的 damages.ConclusionsShort 术语 NRG-1&#x003b2；在体积的试验性的模型的处理罐头营救泵失败导致超载的 HF，它与 GJ 结构和 Cx43 的改进的恢复有关表示。

Effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients

Objective:To discuss the effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients.Method: A total of 90 cases of chronic pulmonary heart disease complicated with respiratory failure patients, who were treated in our hospital between May, 2012 and Feb., 2016, were selected, and were divided into study group (n=45) and control group (n=45) based on random number table. Patients in control group were given auxiliary - control ventilation. (A/C) treatment during the whole course, while patients in study group were given A/C+BiPAP treatment. Cardio-pulmonary function and serum inflammatory factor content difference was compared inboth groups before and after operation.Results: Before treatment, difference ofcardiac function indicator, ABG level and inflammatory factor content in both groups had no statistical significance. After treatment, cardiac function indicator (PASP, RVd) levels in both groups were lower than before treatment, and EFRV levels were higher than before treatment, and changes in study group were more obvious than that in control group;ABG indicator (PaO2) levels in both groups were higher than before treatment, and PaCO2 levels werelower than before treatment, and changes in study group were more obvious than that in control group;serum inflammatory factor (hs-CRP, IL-6, TNF-α) content in both groups was lower than before treatment, and changes in study group were more obvious than that in control group.Conclusion: sequential assist-control ventilation could optimize the cardio-pulmonary function of chronic pulmonary heart disease complicated with respiratory failure patients and reduce the systemic inflammatory response.

Improvement of increased cQTd is associated with heart function in patients with ischemic heart failure

没有及时或有效的干预， BackgroundChronic 心失败(CHF ) 是威胁生活的。在这研究，我们调查了在与 CHF.MethodsFrom 2013年1月在病人为心率( cQTd )和心功能改正到2015年12月的 QT 分散之间的协会，我们连续地注册了作为纽约心协会功能的班( NYHA )分类的 240 个病人有左室的喷射部分( LVEF )的 III-IV <40%。基于病原学，病人被划分成扩大心肌症(DCM ) 组(n = 120 ) 并且一个 ischemic 心肌症(ICM ) 组(n = 120 ) 。基于 cQTd 宽度，然后， ICM 组被划分成二亚群：一个 QS 组(cQTd 60 ms， n = 70 ) 并且一个 QL 组(cQTd > 60 ms， n = 50 ) 。所有病人被 echocardiography 和 12 铅 electrocardiography (ECG ) 在 enrollment.ResultsAfter 以后在 1， 3， 6，和 12 个月检查优化医疗的年，在两个组的病人从基线在 LVEF 和 NYHA 分类显示出重要改进。然而，在 ICM 组的 cQTd，特别 QL，在 DCM 组在是比那显著地短的每次指。另外， cQTd 否定地与 LVEF 和 6-min 走测试被相关并且断然在在场的 ICM group.ConclusionsThe 与 NYHA 班相关调查结果清楚地证明 cQTd 是为在 ICM 病人的后续估计心功能的一个有意义的参数。

Tremendous Improvement of the Functional Capacity in Patient with Chronic Heart Failure after 12-Weeks of Exercise Training Program

Cardiac rehabilitation is recommended for patients with chronic heart failure (CHF) with preserved, or reduced left ventricular ejection fraction (LVEF). A cardiac rehabilitation program generally includes physical exercise, diet counseling, educational classes on lifestyle changes, and disease management as well as psychosocial support for patients and their families. Exercise training is a core component of the comprehensive cardiac rehabilitation program and is strongly recommended in combination with pharmacological treatment to patients with CHF, due to cardiorespiratory, metabolic, and autonomic cardiac response. Exercise-based cardiac rehabilitation affects positively functional capacity, exercise tolerance, and quality of life in CHF patients. The physical inactivity rate in Arabian Peninsula countries is extremely high, and exercise training of habitually physically inactive individuals should result in marked improvements of physical capacity. We present a case that demonstrates such a significant improvement in the physical capacity of a patient with CHF and a review of literature.

Effects of Cardiac Rehabilitation Exercise Protocols on Physical Function in Patients with Chronic Heart Failure: An Experience from a Resource Constraint Nation

Objective: This study investigated the effects of cardiac rehabilitation exercise protocols on physical function (PF) in patients with chronic heart failure (CHF). Study Design and Setting: This randomized controlled trial recruited 70 patients who are in stage II CHF with ejection fraction (≤40%) from a Nigerian university teaching hospital. They were randomly assigned into Exercise Group (EG: n = 35) or Control Group (CG: n = 35). Physical function, activity of daily living (ADL), distance walked in six minutes and grip strength were assessed using a validated ADL questionnaire, six minute walk test and a hand dynamometer respectively. In addition to medication, EG underwent aerobic and upper extremity resistance exercises thrice weekly for eight weeks while CG used medications only. Data were analyzed using descriptive and inferential statistics. Alpha level was at p p > 0.05). Significant improvements were noticed at fourth week among participants’ ADL (30.0% ± 6.0%), 6MWD (321.7 ± 26.3 m) and VO2 max (8.9 ± 0.4 mL/kg/min) variables within the exercise EG but no significant changes were observed in the CG (p > 0.05). Participants in EG demonstrated more significant improvements in ADL (15.0% ± 5.0%), 6MWD (406.0 ± 29.7 m) and VO2 max (10.3 ± 0.5 mL/kg/min) (p p > 0.05). Conclusions: Cardiac rehabilitation exercise protocols involving self-paced walking, sit-to-stand and upper extremity dynamic strength training improved activity of daily living, walking and functional capacity in patients with stable chronic heart failure.

Effect of Trimetazidine Dihydrochloride Tablets adjuvant therapy on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure

Objective: To investigate the effects of Trimetazidine Dihydrochloride Tablets on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure. Methods: A total of 98 patients with coronary heart disease and heart failure who met the criteria of the study were selected as the subjects, based on the random data table they were divided into the control group (n=49) and observation group (n=49), the patients in the control group were treated with Metoprolol Tartrate Sustained-release Tablets treatment, and the patients in the observation group were treated with Metoprolol Tartrate Sustained-release Tablets combined with Trimetazidine Dihydrochloride Tablets, the levels of inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function indexes were compared between the two groups before and after treatment. Results: The difference of the CRP, TNF-α, MDA, SOD, NO, ET-1, LVEF, LVEDD and LVESD levels in the two groups before treatment were not statistically significant;Compared with the levels of the two groups before treatment, the two groups of CRP, TNF-α, MDA, ET-1, LVEDD and LVESD levels after treatment were significantly decreased, and the level of the observation group after treatment was significantly lower than those levels in the control group, the difference was statistically significant;The levels of SOD, NO and LVEF of the two groups after treatment were significantly higher than those in the same group before treatment, and the observation group levels [(88.09±7.51) U/ml, (72.58±14.64) mol/L, (48.34±5.09)% ] were significantly higher than the control group [(79.44±7.27) U/ml, (61.89±11.06) mol/L, (44.19±4.58)%], the difference was statistically significant. Conclusion: Trimetazidine Dihydrochloride Tablets in the treatment of coronary heart disease with heart failure can effectively inhibit the release of inflammatory factors, improve oxidative stress state, vascular endothelial function and myocardial function, has an important clinical value.

Effect of trimetazidine combined with bisoprolol on the cardiac function, ventricular remodeling and neuroendocrine factors in patients with chronic heart failure

Objective:To study the effect of trimetazidine combined with bisoprolol on the cardiac function, ventricular remodeling and neuroendocrine factors in patients with chronic heart failure.Methods: A total of 52 patients with chronic heart failure who were treated in our hospital between January 2012 and November 2015 were collected and divided into the control group (n=26) who received bisoprolol therapy and the observation group (n=26) who received trimetazidine combined with bisoprolol therapy according to the double-blind randomized control method, and both groups were treated for 3 months. Before treatment and after 3 months of treatment, cardiac color Doppler diasonograph was used to determine the levels of cardiac function parameters and ventricular remodeling parameters, and RIA method was used to determine the levels if peripheral blood neuroendocrine factors.Results: Before treatment, the differences in cardiac function, ventricular remodeling and neuroendocrine factor levels were not statistically significant between two groups of patients. After 3 months of treatment, cardiac function parameters LVEDd and LVESD levels of observation group were lower than those of control group while LVEF level was higher than that of control group, and ventricular remodeling parameters LVPWT, IVSS, PWD, PWS and LVMI levels were lower than those of control group;peripheral blood neuroendocrine factors NE, ALD, AngⅡ, ANP and ET contents of observation group were lower than those of control group.Conclusion:Trimetazidine combined with bisoprolol can optimize the cardiac function, suppress the ventricular remodeling process and regulate the neuroendocrine factor secretion in patients with chronic heart failure, and it contributes to the patients' overall optimization.

Left ventricular systolic function assessment in patients with dilated heart failure using cardiovascular magnetic resonance

Cardiovascular magnetic resonance (CMR) has become a reference standard for the measure-ment of cardiac volumes, function, and mass. This study aims to reconstruct three dimen-sional modeling of the left ventricle (LV) in pa-tients with heart failure (HF) using CMRtools and thereby derive the LV functional indices. CMR images were acquired in 41 subjects (6 females) with heart failure (HF) and 12 normal controls (4 females). Five comparisons were made (i) nor-mal and dilated heart failure subjects, (ii) male and female normal heart, (iii) male and female dilated heart, (iv) male normal and dilated heart failure and (v) female normal and dilated heart failure. In HF, a significant higher values of EDV (320 刡 79 vs. 126 刡 22 ml, P&amp;amp;amp;amp;amp;lt;0.0001), ESV (255 刡 68 vs. 54 刡 12 ml, P&amp;amp;amp;amp;amp;lt;0.00001) and lower values of EF (20 刡 7 vs. 58 刡 5 %) were found compared that of normal control. There were significant difference on LV EDV and ESV between sex in both normal and HF subjects.