Effect of amiodarone combined with irbesartan on N-terminal pro brain natriuretic peptide, inflammatory factors and ventricular function in patients with rheumatic heart disease
Zou Qingmei
Huang Lin
Liu Yao
Zhang Yaxi
Gao Jinquan
Abstract：Objective To investigate the effect of amiodarone combined with irbesartan on N-terminal pro brain natriuretic peptide,inflammatory factors and ventricular function in patients with rheumatic heart disease.Methods The 122 cases of rheumatic heart disease were enrolled.Patients were randomly divided into amiodarone group and irbesartan plus amiodarone group according to the treatments,with 61 cases in each group.Amiodarone group only received oral amiodarone hydrochloride tablets,but irbesartan plus amiodarone group were given the amiodarone hydrochloride and irbesartan tablets; the treatment lasted for 10 weeks.The changed level of left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular end systolic volume (LVESV),left ventricular end diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were comapred between two groups before and after treatment.The level of inflammatory cytokine interleukin-4,6,8 10,and tumor necrosis factor alpha (TNF-α) were detected by enzyme linked immunosorbent assay;high sensitive C reactive protein (hs-CRP) was tested by latex enhanced immune transmission turbidity; N terminal pro brain natriuretic peptide was determined by flow immune method.The hemodynamic parameters including heart rate,mean arterial pressure,central venous pressure,cardiac index and pulmonary capillary wedge pressure variations were also compared between two groups.Results After the treatment,levels of LVEDD,LVESD,LVESV,LVEDV and LVEF in irbesartan + amiodarone group were significantly better than those in amiodarone group [LVEDD:(40 ±5)mm vs (46 ±5)mm,LVESD:(24.7 ±3.0)mm vs (35.4 ±3.3)mm,LVESV:(52 ±5)ml vs (43 ±3)ml,LVEDV:(84 ± 16)ml vs (80 ± 17)ml,LVEF:(56 ±8)％ vs (36 ±7)％] (P ＜0.05) ;levels of IL-4,IL-6,IL-8,IL-10,TNF-α,hs-CRP and N terminal pro brain natriuretic peptide in irbesartan plus amiodarone group were more reduced compared with amiodarone group [IL-4:(16 ± 4) ng/L vs (25 ± 6) ng/L,IL-6:(89 ± 19) ng/L vs (102 ±29)ng/L,IL-8:(24 ±4)ng/L vs (31 ±4)ng/L,IL-10:(38 ±6)ng/L vs (28 ±5)ng/L,TNF-α:(42 ± 9) ng/L vs (50 ± 10) ng/L,hs-CRP:(2.1 ± 0.7) mg/L vs (3.0 ± 0.8) mg/L,N terminal pro brain natriuretic peptide:(94 ± 21) ng/L vs (103 ± 23) ng/L] (P ＜ 0.05) ; cardiac index of irbesartan plus amiodarone group is obviously superior to amiodarone group [(3.9 ± 0.4) L/(min · m2) vs (1.9 ± 0.4) L/(min · m2)].Four cases in irbesartan + amiodarone group had mild gastrointestinal reactions and 2 cases had mild gastrointestinal in amiodarone group.Conlcusion Irbesartan combined with amiodarone can reduce the levels of N terminal pro brain natriuretic peptide and inflammatory factors in patients with rheumatic heart disease,which improves cardiac function.
Keywords：Rheumatic heart diseaseIrbesartanAmiodaroneVentricular functionN-terminal-pro brain natriuretic peptideInflammatory factor
Publication Date：2015-03-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 296-300 )