Curative Effect of Metoprolol Combined Simvastatin on Chronic Congestive Heart Failure and Impact on Ventricular Remodeling

ZHANG Sheng; HE Shun-de

doi:10.3969/j.issn.1002-3429.2015.11.029

Abstract：Objective To observe the curative effect of Metoprolol combined Simvastatin on chronic congestive heart failure ( CHF) and the effects on ventricular remodeling. Methods 119 patients who met the inclusion criteria and exclusion criteria during November 2012 and November 2013 in the First People's Hospital of Ziyang were included in the research and were divided into control group (56 cases) and observation group (63 cases) according to the treatment. Both the two groups received conventional treatment, and the control group received additional Metoprolol Succinate sustained-release tablets on the basis of conventional treatment, and observation group was combined with Simvastatin on the basis of treatment of the control group. Clinical curative effect, cardiac function indexes and serum myocardial remodeling associated factors, matrix metallo-proteinases (MMP)-3 and MMP-9, and adverse reactions of the two groups were compared and correlation analysis of serum myocardial remodeling associated factors, and the parameters of echocardiography were performed. The value of serum MMP-3 and MMP-9 in the diagnosis of CHF was evaluated. Results After treatment, the total effective rate of the control group was lower than that of the observation group, and the differences were of statistical significance (P>0. 05). After the treat-ment, cardiac function indexes of the two group were obviously improved, and the improvement of cardiac function index in the control group was significantly less than that of the observation group;concentration of serum myocardial remodeling associated factors, MMP-3, MMP-9 in the two groups were lower than that before the treatment, the reduction of the control group was significantly less than that of the observation group, and the differences were of statistical significance (P<0. 05). The com-parison of the adverse reaction rates between the two groups had no statistical significances (P>0. 05). Correlation analysis showed that serum concentration of MMP-3, MMP-9 and echocardiographic parameters were correlated, serum MMP-3, MMP-9 showed negative correlation with LVEF and LVFS, and positive correlation with LVDD and LVSD. Serum levels of MMP-3 and MMP-9 both had ideal diagnostic sensitivity and specific degree of CHF. Conclusion Metoprolol combined with Simvas-tatin can obviously improve the cardiac function in patients with CHF, and the cause may be related to the reduction of serum myocardial remodeling associated factors, MMP-3 and MMP-9.